Ligation of patent ductus arteriosus in very low birth weight premature infants.
Ductus Arteriosus, Patent
/ surgery
Enterocolitis, Necrotizing
Female
Fetal Growth Retardation
/ epidemiology
Hemorrhage
/ epidemiology
Humans
Infant
Infant, Newborn
Infant, Premature
Infant, Small for Gestational Age
Infant, Very Low Birth Weight
Ligation
/ trends
Lung Diseases
/ epidemiology
Male
Pregnancy
Prevalence
United States
/ epidemiology
PDA ligation
mortality
necrotizing enterocolitis
preterm neonates
Journal
Pediatrics and neonatology
ISSN: 2212-1692
Titre abrégé: Pediatr Neonatol
Pays: Singapore
ID NLM: 101484755
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
received:
19
04
2019
revised:
16
01
2020
accepted:
18
03
2020
pubmed:
13
4
2020
medline:
23
12
2020
entrez:
13
4
2020
Statut:
ppublish
Résumé
Patent ductus arteriosus (PDA) is frequently encountered in premature infants. Optimal management of PDA remains undefined. We aim to assess the national trend for PDA ligation over 18 years and evaluate mortality and associated morbidities. We used data from the National Inpatient Sample (NIS) and KID of the Healthcare Cost and Utilization Project (HCUP) from 1998 to 2015. All infants with gestational age 24-32 weeks and birth weight <1500 g were included. Patients with PDA were classified into two groups: those who did and did not receive surgical ligation. Associated mortality and morbidities were compared. A total of 429,900 neonatal admissions were identified. Of them, 149,473 (34.8%) infants had PDA. PDA-ligated infants were 27,364 (6.4%). PDA ligation was more likely in those with smaller gestational age and with birth weight <1000 g. A steady decline in PDA ligation was noticed since 2004. The mortality rate in PDA-ligated infants was less than in PDA-non-ligated infants (7.5% vs. 8.9%; OR = 0.82; 95% CI: 0.78-0.86; p < 0.001). However, the prevalence rates of pulmonary hemorrhage and necrotizing enterocolitis (NEC) were greater in PDA-ligated infants (OR = 1.58; 95% CI: 1.49-1.67; p < 0.001, and OR = 1.32; 95% CI: 1.26-1.38; p < 0.001, respectively). Ligation of PDA has been steadily declining since 2004. Despite higher morbidities, PDA-ligated infants had less mortality.
Sections du résumé
BACKGROUND
Patent ductus arteriosus (PDA) is frequently encountered in premature infants. Optimal management of PDA remains undefined. We aim to assess the national trend for PDA ligation over 18 years and evaluate mortality and associated morbidities.
METHODS
We used data from the National Inpatient Sample (NIS) and KID of the Healthcare Cost and Utilization Project (HCUP) from 1998 to 2015. All infants with gestational age 24-32 weeks and birth weight <1500 g were included. Patients with PDA were classified into two groups: those who did and did not receive surgical ligation. Associated mortality and morbidities were compared.
RESULTS
A total of 429,900 neonatal admissions were identified. Of them, 149,473 (34.8%) infants had PDA. PDA-ligated infants were 27,364 (6.4%). PDA ligation was more likely in those with smaller gestational age and with birth weight <1000 g. A steady decline in PDA ligation was noticed since 2004. The mortality rate in PDA-ligated infants was less than in PDA-non-ligated infants (7.5% vs. 8.9%; OR = 0.82; 95% CI: 0.78-0.86; p < 0.001). However, the prevalence rates of pulmonary hemorrhage and necrotizing enterocolitis (NEC) were greater in PDA-ligated infants (OR = 1.58; 95% CI: 1.49-1.67; p < 0.001, and OR = 1.32; 95% CI: 1.26-1.38; p < 0.001, respectively).
CONCLUSIONS
Ligation of PDA has been steadily declining since 2004. Despite higher morbidities, PDA-ligated infants had less mortality.
Identifiants
pubmed: 32278743
pii: S1875-9572(20)30048-6
doi: 10.1016/j.pedneo.2020.03.009
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
399-405Informations de copyright
Copyright © 2020. Published by Elsevier B.V.
Déclaration de conflit d'intérêts
Declaration of Competing Interest All authors have no financial relationships relevant to this article to disclose.