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

• Published in: The Journal of pediatrics Vol. 203; pp. 170 - 176.e1
• Main Authors: Collins, R. Thomas, Lyle, Robert E., Rettiganti, Mallikarjuna, Gossett, Jeffrey M., Robbins, James M., Casey, Patrick H.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2018
• Subjects: 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; low birth weight; Male; Neurodevelopmental Disorders - diagnosis; Neurodevelopmental Disorders - epidemiology; neurodevelopmental outcome; patent ductus arteriosus; preterm; Risk Assessment; Time; Time Factors; PPVT-R; IPW; WJ; neurodevelopmental outcome; CBCL; preterm; WASI; IHDP; patent ductus arteriosus; low birth weight; WISC-III; PDA
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2018.08.004

To evaluate whether the presence of patent ductus arteriosus (PDA) in preterm infants worsens long-term neurodevelopmental outcomes. 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. 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. The presence of a PDA in moderately preterm, low-birthweight infants does not impact long-term neurodevelopmental outcomes.