Long-Term Neurodevelopment of Low-Birthweight, Preterm Infants with Patent Ductus Arteriosus

J Pediatr. 2018 Dec:203:170-176.e1. doi: 10.1016/j.jpeds.2018.08.004. Epub 2018 Sep 26.

Abstract

Objective: To evaluate whether the presence of patent ductus arteriosus (PDA) in preterm infants worsens long-term neurodevelopmental outcomes.

Study design: This was a secondary observational analysis of data from 1090 preterm low-birthweight infants in the Infant Health and Development Program (IHDP), a multicenter longitudinal cohort study of outcomes assessed from 3 to 18 years of age. Multivariable analysis was adjusted for IHDP treatment group (intervention or follow-up), birth weight, maternal race, maternal education, infant sex, maternal preconception weight, Home Observation Measurement of the Environment (HOME) total score at 12 months, neonatal health index, and gestational age.

Results: Of the 1090 patients (49% male) included in the analysis, 135 had a PDA. Mean birth weight (1322 g vs 1871 g; P < .0001) and gestational age (30.2 weeks vs 33.4 weeks, P < .0001) were lower and mean ventilator days (11.8 vs 1.3; P < .0001), vasopressor use (12.6% vs 1.2%; P < .0001), and congestive heart failure (8.9% vs 0.1%; P < .0001) were higher in the PDA group. There were no differences between the PDA and no-PDA groups in maternal education level and HOME total score at age 12 months. Multivariable analysis demonstrated no between-group differences in cognitive development or behavioral competence at age 3, 8, and 18 years.

Conclusions: The presence of a PDA in moderately preterm, low-birthweight infants does not impact long-term neurodevelopmental outcomes.

Keywords: low birth weight; neurodevelopmental outcome; patent ductus arteriosus; preterm.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adolescent
  • Age Factors
  • Child
  • Child, Preschool
  • Cyclooxygenase Inhibitors / therapeutic use
  • Ductus Arteriosus, Patent / diagnosis*
  • Ductus Arteriosus, Patent / drug therapy*
  • Female
  • Follow-Up Studies
  • Humans
  • Ibuprofen / therapeutic use
  • Incidence
  • Indomethacin / therapeutic use
  • Infant
  • Infant, Low Birth Weight*
  • Infant, Newborn
  • Infant, Premature*
  • Longitudinal Studies
  • Male
  • Neurodevelopmental Disorders / diagnosis*
  • Neurodevelopmental Disorders / epidemiology
  • Risk Assessment
  • Time
  • Time Factors

Substances

  • Cyclooxygenase Inhibitors
  • Ibuprofen
  • Indomethacin