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Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
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Premature infants with patent ductus arteriosus: Postnatal growth according to type of management

Kunal Babla1, Theodore Dassios2, Kuberan Pushparajah3

  • 1Neonatal Intensive Care Unit, King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE9 9RS, UK; GKT School of Medical Education, King's College London, London, UK.

Pediatrics and Neonatology
|August 25, 2020
PubMed

Insights

Surgical management of Patent Ductus Arteriosus (PDA) in premature infants is linked to more significant growth impairment compared to medical or conservative approaches. This finding highlights potential long-term growth implications of PDA treatment strategies.

Area of Science:

  • Neonatology
  • Pediatric Cardiology
  • Growth and Development

Background:

  • Patent Ductus Arteriosus (PDA) is a common condition in preterm infants, particularly those born before 28 weeks' gestation.
  • PDA is associated with impaired growth, but the impact of different management strategies on growth faltering is not well understood.

Purpose of the Study:

  • To compare weight gain at 36 weeks' corrected gestational age (CGA) in premature infants managed medically, surgically, or conservatively for PDA.
  • To investigate the association between PDA treatment modality and growth impairment in preterm infants.

Main Methods:

  • Retrospective review of 208 infants born before 30 weeks' gestation with PDA.
  • Data collected included gestational age at birth, birth weight z-score, and weight z-score at 36 weeks' CGA.
  • Infants underwent surgical closure if they remained symptomatic after medical or conservative management.

Main Results:

  • Surgically managed infants had a lower median gestational age at birth compared to medically or conservatively managed infants.
  • No difference in birth weight z-scores was observed across the groups.
  • Surgically managed infants showed a significantly greater decrease in weight z-score from birth to 36 weeks' CGA compared to other groups, even after adjusting for gestational age at birth.

Conclusions:

  • Premature infants with PDA treated surgically experienced more pronounced growth faltering by 36 weeks' corrected gestational age.
  • The findings suggest that the chosen management strategy for PDA may influence long-term growth outcomes in preterm infants.
Abstract

Keywords:
ligationneonatalpatent ductus arteriosusprematurity

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