Premature infants with patent ductus arteriosus: Postnatal growth according to type of management.
Cardiac Surgical Procedures
Conservative Treatment
Ductus Arteriosus, Patent
/ physiopathology
Female
Gestational Age
Growth Disorders
/ diagnosis
Humans
Infant
Infant, Low Birth Weight
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases
/ physiopathology
Male
Postoperative Complications
/ diagnosis
Retrospective Studies
Weight Gain
ligation
neonatal
patent ductus arteriosus
prematurity
Journal
Pediatrics and neonatology
ISSN: 2212-1692
Titre abrégé: Pediatr Neonatol
Pays: Singapore
ID NLM: 101484755
Informations de publication
Date de publication:
01 2021
01 2021
Historique:
received:
18
02
2020
revised:
22
06
2020
accepted:
05
08
2020
pubmed:
25
8
2020
medline:
29
6
2021
entrez:
25
8
2020
Statut:
ppublish
Résumé
Patent Ductus Arteriosus (PDA) is a common condition, affecting nearly half of infants born before 28 weeks' of gestation, and it has been associated with poor growth. It is not known if different treatment modalities are associated with more profound growth impairment. Our aim was to compare differences in weight gain at 36 weeks' corrected gestational age (CGA) in premature infants that received medical, surgical or conservative management for PDA. We retrospectively reviewed notes of 208 infants born under 30 weeks' gestation with a diagnosis of PDA. Gestational age (GA) at birth, birth weight z-score, CGA and weight z-score at 36 weeks' CGA were collected. In our cohort, surgical closure was performed in infants who remained symptomatic after medical or conservative management. Ninety-four infants had medical, 56 surgical and 58 conservative management. Surgically managed infants had a lower median (IQR) GA [24.4 (24.0-26.1) weeks'] than medically [25.4 (24.6-26.5) weeks'] or conservatively managed [26.4 (25.4-28.1) weeks', p < 0.001] infants. There was no difference in birth weight z-scores across the groups. Surgically managed infants demonstrated a greater decrease in weight z-score [-2.24 (-2.89 to -1.53)] compared to medically [-1.79 (-2.45 to -1.35)] and conservatively [-1.57 (-1.99 to -1.28), p < 0.001] managed infants between birth and 36 weeks' CGA. After adjusting for GA at birth, definitive treatment modality was significantly related to change in weight z-score from birth to 36 weeks' CGA (adjusted p = 0.022). Premature infants with PDA who were managed surgically had a greater degree of faltering growth compared to those who were treated medically or conservatively.
Sections du résumé
BACKGROUND
Patent Ductus Arteriosus (PDA) is a common condition, affecting nearly half of infants born before 28 weeks' of gestation, and it has been associated with poor growth. It is not known if different treatment modalities are associated with more profound growth impairment. Our aim was to compare differences in weight gain at 36 weeks' corrected gestational age (CGA) in premature infants that received medical, surgical or conservative management for PDA.
METHODS
We retrospectively reviewed notes of 208 infants born under 30 weeks' gestation with a diagnosis of PDA. Gestational age (GA) at birth, birth weight z-score, CGA and weight z-score at 36 weeks' CGA were collected. In our cohort, surgical closure was performed in infants who remained symptomatic after medical or conservative management.
RESULTS
Ninety-four infants had medical, 56 surgical and 58 conservative management. Surgically managed infants had a lower median (IQR) GA [24.4 (24.0-26.1) weeks'] than medically [25.4 (24.6-26.5) weeks'] or conservatively managed [26.4 (25.4-28.1) weeks', p < 0.001] infants. There was no difference in birth weight z-scores across the groups. Surgically managed infants demonstrated a greater decrease in weight z-score [-2.24 (-2.89 to -1.53)] compared to medically [-1.79 (-2.45 to -1.35)] and conservatively [-1.57 (-1.99 to -1.28), p < 0.001] managed infants between birth and 36 weeks' CGA. After adjusting for GA at birth, definitive treatment modality was significantly related to change in weight z-score from birth to 36 weeks' CGA (adjusted p = 0.022).
CONCLUSION
Premature infants with PDA who were managed surgically had a greater degree of faltering growth compared to those who were treated medically or conservatively.
Identifiants
pubmed: 32830076
pii: S1875-9572(20)30132-7
doi: 10.1016/j.pedneo.2020.08.005
pii:
doi:
Types de publication
Comparative Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
36-40Subventions
Organisme : Medical Research Council
ID : MC_PC_14105
Pays : United Kingdom
Organisme : Department of Health
Pays : United Kingdom
Informations de copyright
Copyright © 2020. Published by Elsevier B.V.
Déclaration de conflit d'intérêts
Declaration of Competing Interest No conflicts of interest to declare.