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Patent ductus arteriosus treatment trends and associated morbidities in neonates

Joonsik Park1, So J Yoon1, Jungho Han1

  • 1Department of Pediatrics, Yonsei University College of Medicine, 211 Eonjuro Gangnamgu, Seoul, 06273, Republic of Korea.

Scientific Reports
|May 22, 2021
PubMed

Insights

The prevalence of patent ductus arteriosus (PDA) in Korean infants increased from 2015-2018. Conservative management of PDA improved outcomes in very low birth weight infants, though surgery remains an option for select cases.

Area of Science:

  • Neonatal Medicine
  • Pediatric Cardiology
  • Public Health Epidemiology

Background:

  • Patent ductus arteriosus (PDA) is a common condition in neonates, particularly those who are very low birth weight (VLBW).
  • Treatment strategies for PDA vary, including medical management and surgical intervention, with differing associated outcomes.
  • Understanding national trends in PDA diagnosis and treatment is crucial for optimizing infant care.

Purpose of the Study:

  • To analyze national epidemiologic data on infants diagnosed with PDA in Korea.
  • To evaluate treatment patterns and associated outcomes for PDA in infants.
  • To assess trends in PDA prevalence and management from 2015 to 2018.

Main Methods:

  • Retrospective analysis of 12,336 infants diagnosed with PDA (ICD-10 code: Q250) between 2015-2018 using the Health Insurance Review and Assessment database.
  • Utilized birth certificate data from Statistics Korea to determine PDA prevalence.
  • Categorized treatments into conservative, intravenous ibuprofen, surgery, and oral ibuprofen.

Main Results:

  • PDA prevalence was 81 per 10,000 live births, and 45.2% in VLBW infants, showing an increasing trend.
  • Surgical ligation was performed in 20.4% of all infants and 22.2% of VLBW infants.
  • Conservative treatment increased, while medical treatment decreased, especially in VLBW infants (62% to 53%).
  • Surgical treatment was associated with a significantly higher mortality risk (OR 1.36) compared to conservative treatment.
  • Both surgical and medical treatments increased the risk of morbidity.

Conclusions:

  • Increased use of conservative PDA management has improved neonatal outcomes in VLBW infants.
  • Surgical ligation for PDA carries a higher mortality risk and is associated with increased morbidity.
  • Careful patient selection is essential for those who may still benefit from surgical intervention for PDA.

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