title: Neurodevelopmental Outcome at 2 Years of Age according to Patent Ductus Arteriosus Management in Very Preterm Infants.
abstract: BACKGROUND
  Patent ductus arteriosus (PDA) is a condition frequently found in very preterm infants, and its treatment remains a subject of debate. Furthermore, there are only a few studies available that have examined the impact of these treatments on the neurological outcome of the patient.
  
  
  OBJECTIVE
  To evaluate the neurodevelopmental outcome of PDA treatment on preterm infants born between 24+0 and 28+6 weeks of gestation.
  
  
  METHODS
  We conducted an observational multicentric cohort study (LIFT Cohort). We compared three groups of patients according to their PDA treatment strategy: medical treatment with ibuprofen, surgical ligation, and no treatment. The neurodevelopmental outcome was assessed with a physical examination and cognitive function evaluation at 2 years of age. A propensity score was used to reduce bias in the analysis.
  
  
  RESULTS
  Between 2003 and 2011, 857 infants (91.3%) were evaluated at 2 years of corrected age and included in the analysis: 248 received ibuprofen treatment (29%), 104 had PDA surgical ligation (12%), and 505 did not receive any PDA treatment (59%). Surgical ligation of PDA was significantly associated with neurodevelopmental impairment at 2 years of age (adjusted odds ratio = 2.2; 95% confidence interval: 1.4-3.4).
  
  
  CONCLUSIONS
  We found an association between PDA surgical ligation and a nonoptimal neurodevelopmental outcome at 2 years of age for preterm infants born before 29 weeks of gestation. These results suggest that if surgical ligation is unavoidable, particular attention should be given to the patient's neurodevelopmental follow-up.
authors.affiliation: Department of Neonatal Medicine, University Hospital of Angers, Angers, France.
authors.forename: Laura
authors.initials: L
authors.lastname: Bourgoin
authors.forename: Cecile
authors.initials: C
authors.lastname: Cipierre
authors.forename: Quentin
authors.initials: Q
authors.lastname: Hauet
authors.forename: Helene
authors.initials: H
authors.lastname: Basset
authors.forename: Veronique
authors.initials: V
authors.lastname: Gournay
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Rozé
authors.forename: Cyril
authors.initials: C
authors.lastname: Flamant
authors.forename: Geraldine
authors.initials: G
authors.lastname: Gascoin
mesh_terms: D002675:Child, Preschool; D015331:Cohort Studies; D016861:Cyclooxygenase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D004374:Ductus Arteriosus, Patent / Q000150:complications* / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007052:Ibuprofen / Q000009:adverse effects / Q000627:therapeutic use; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D065886:Neurodevelopmental Disorders / Q000209:etiology*; D011597:Psychomotor Performance; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D016861:Cyclooxygenase Inhibitors; D007052:Ibuprofen