Related Experiment Video
Updated: Mar 28, 2026
Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
Published on: January 27, 2023
Neurodevelopmental Outcome at 2 Years of Age according to Patent Ductus Arteriosus Management in Very Preterm Infants
Laura Bourgoin1, Cecile Cipierre, Quentin Hauet
1Department of Neonatal Medicine, University Hospital of Angers, Angers, France.
Insights
Surgical closure of patent ductus arteriosus (PDA) in very preterm infants is linked to poorer neurodevelopmental outcomes. This suggests careful follow-up is crucial if surgical intervention for PDA is necessary.
Area of Science:
- Neonatal Medicine
- Developmental Pediatrics
- Surgical Outcomes
Background:
- Patent ductus arteriosus (PDA) is common in very preterm infants, with treatment strategies debated.
- Limited research exists on the neurological impact of PDA treatments in this population.
Purpose of the Study:
- To assess the neurodevelopmental outcomes of preterm infants (24–28 weeks gestation) based on their PDA treatment.
- To compare outcomes between medical (ibuprofen), surgical, and no PDA treatment.
Main Methods:
- Observational multicentric cohort study (LIFT Cohort) of 857 infants evaluated at 2 years corrected age.
- Comparison of neurodevelopmental outcomes across ibuprofen, surgical ligation, and no PDA treatment groups.
- Propensity score analysis to mitigate bias.
Main Results:
- Surgical PDA ligation was significantly associated with neurodevelopmental impairment at 2 years (aOR=2.2; 95% CI: 1.4-3.4).
- Of 857 infants, 29% received ibuprofen, 12% had surgical ligation, and 59% received no PDA treatment.
Conclusions:
- PDA surgical ligation in preterm infants (<29 weeks gestation) is associated with nonoptimal neurodevelopmental outcomes.
- Increased attention to neurodevelopmental follow-up is recommended when PDA surgical ligation is unavoidable.
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).
Conclusion:
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.
