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Patent ductus arteriosus and small for gestational age infants: Treatment approaches and outcomes

Jose Carlos Aldana-Aguirre1, Jennifer Toye1, Prakesh S Shah2

  • 1Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada.

Early Human Development
|February 17, 2019
PubMed

Insights

Patent ductus arteriosus treatment is similar for small for gestational age infants, but these infants face higher risks of death or bronchopulmonary dysplasia. This highlights a critical need for focused care in this high-risk neonatal population.

Area of Science:

  • Neonatal Medicine
  • Pediatric Cardiology
  • Perinatology

Background:

  • Patent ductus arteriosus (PDA) treatment focuses on high-risk infants.
  • Small for gestational age (SGA) infants are a high-risk group with uncharacterized PDA treatment and outcomes.
  • Understanding PDA management in SGA neonates is crucial for improving care.

Purpose of the Study:

  • To compare PDA treatment approaches and outcomes in SGA versus appropriate for gestational age (AGA) infants.
  • To evaluate the impact of PDA on neonatal outcomes in SGA infants.
  • To inform clinical practice regarding PDA management in vulnerable neonatal populations.

Main Methods:

  • Retrospective analysis of neonates born <33 weeks' gestational age (GA) between 2011-2015.
  • Inclusion of infants from the Canadian Neonatal Network.
  • Comparison of PDA treatment strategies (conservative, medical, surgical) and outcomes between SGA and AGA infants.

Main Results:

  • PDA prevalence was similar in SGA (23.7%) and AGA (23.6%) infants.
  • PDA treatment approaches were comparable across both groups.
  • SGA infants, with or without PDA, showed an increased risk of death or bronchopulmonary dysplasia.

Conclusions:

  • PDA management strategies do not differ between SGA and AGA infants.
  • SGA infants exhibit a higher risk of adverse outcomes, including death or bronchopulmonary dysplasia, irrespective of PDA status.
  • Further research is needed to address the heightened vulnerability of SGA infants.
Abstract

Keywords:
Appropriate for gestational agePatent ductus arteriosusPremature infantsSmall for gestational age

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