Spontaneous Closure of Patent Ductus Arteriosus in Infants ≤1500 g

被引:136
作者
Semberova, Jana [1 ,2 ]
Sirc, Jan [2 ,3 ]
Miletin, Jan [1 ,2 ,3 ,4 ]
Kucera, Jachym [2 ]
Berka, Ivan [2 ]
Sebkova, Sylva [2 ]
O'Sullivan, Sinead [1 ]
Franklin, Orla [5 ]
Stranak, Zbynek [2 ,3 ]
机构
[1] Coombe Women & Infants Hosp, Dept Neonatol, Dublin, Ireland
[2] Inst Care Mother & Child, Prague, Czech Republic
[3] Charles Univ Prague, Fac Med 3, Prague, Czech Republic
[4] UCD, Sch Med & Med Sci, Dublin, Ireland
[5] Our Ladys Childrens Hosp Crumlin, Dept Paediat Cardiol, Dublin, Ireland
关键词
BIRTH-WEIGHT INFANTS; INDOMETHACIN PROPHYLAXIS; BRONCHOPULMONARY DYSPLASIA; PRETERM INFANTS; TRIAL; UNIT;
D O I
10.1542/peds.2016-4258
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
OBJECTIVES: Patent ductus arteriosus (PDA) remains a challenging issue in very low birth weight (VLBW) infants, and its management varies widely. Our aim in this study was to document the natural course of ductus arteriosus in a cohort of VLBW infants who underwent conservative PDA management with no medical or surgical intervention. METHODS: A retrospective cohort study conducted in 2 European level-3 neonatal units. RESULTS: A total of 368 VLBW infants were born within the study period. Two hundred and ninety-seven infants were free of congenital malformations or heart defects and survived to hospital discharge. Out of those, 280 infants received truly conservative PDA management. In 237 (85%) of nontreated infants, the PDA closed before hospital discharge. The Kaplan-Meier model was used to document the incidence proportion of PDA closure over time for different gestational age groups. The median time to ductal closure was 71, 13, 8, and 6 days in <26+0, 26+0 to 27+6, 28+0 to 29+6, and >= 30 weeks, respectively. For different birth weight groups, the median was 48, 22, 9, and 8 days in infants weighing <750, 750 to 999, 1000 to 1249, and 1250 to 1500 g, respectively. No statistically significant relationship was found between PDA closure before hospital discharge and neonatal morbidities. CONCLUSIONS: The likelihood of PDA spontaneous closure in VLBW infants is extremely high. We provide in our findings a platform for future placebo-controlled trials focused on the smallest and youngest infants.
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页数:8
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