TY - JOUR
T1 - Delayed Surgical Closure of the Patent Ductus Arteriosus
T2 - does the Brain pay the Price?
AU - Lemmers, Petra
AU - Vijlbrief, Daniel
AU - Benders, Manon
AU - Alderliesten, Thomas
AU - Veldhuis, Moniek
AU - Baerts, Wim
AU - Koopman-Esseboom, Corine
AU - Groenendaal, Floris
AU - van Bel, Frank
N1 - Funding Information:
We thank Femke Lammertink for her support in data collection and interpretation of the MRIs of the brain and preparation of the manuscript. She has no conflicts of interest. Funding source: Wilhelmina Children's Hospital Foundation Utrecht NL.
Publisher Copyright:
© 2022 The Author(s)
PY - 2023/3
Y1 - 2023/3
N2 - Objective: To investigate the relation between duration of hemodynamically significant patent ductus arteriosus (PDA), cerebral oxygenation, magnetic resonance imaging–determined brain growth, and 2-year neurodevelopmental outcome in a cohort of infants born preterm whose duct was closed surgically. Study design: Infants born preterm at <30 weeks of gestational age who underwent surgical ductal closure between 2008 and 2018 (n = 106) were included in this observational study. Near infrared spectroscopy–monitored cerebral oxygen saturation during and up to 24 hours after ductal closure and a Bayley III developmental test at the corrected age of 2 years is the institutional standard of care for this patient group. Infants also had magnetic resonance imaging at term-equivalent age. Results: In total, 90 infants fulfilled the inclusion criteria (median [range]: 25.9 weeks [24.0-28.9]; 856 g [540-1350]. Days of a PDA ranged from 1 to 41. Multivariable linear regression analysis showed that duration of a PDA negatively influenced cerebellar growth and motor and cognitive outcome at 2 years of corrected age. Conclusions: Prolonged duration of a PDA in this surgical cohort is associated with reduced cerebellar growth and suboptimal neurodevelopmental outcome.
AB - Objective: To investigate the relation between duration of hemodynamically significant patent ductus arteriosus (PDA), cerebral oxygenation, magnetic resonance imaging–determined brain growth, and 2-year neurodevelopmental outcome in a cohort of infants born preterm whose duct was closed surgically. Study design: Infants born preterm at <30 weeks of gestational age who underwent surgical ductal closure between 2008 and 2018 (n = 106) were included in this observational study. Near infrared spectroscopy–monitored cerebral oxygen saturation during and up to 24 hours after ductal closure and a Bayley III developmental test at the corrected age of 2 years is the institutional standard of care for this patient group. Infants also had magnetic resonance imaging at term-equivalent age. Results: In total, 90 infants fulfilled the inclusion criteria (median [range]: 25.9 weeks [24.0-28.9]; 856 g [540-1350]. Days of a PDA ranged from 1 to 41. Multivariable linear regression analysis showed that duration of a PDA negatively influenced cerebellar growth and motor and cognitive outcome at 2 years of corrected age. Conclusions: Prolonged duration of a PDA in this surgical cohort is associated with reduced cerebellar growth and suboptimal neurodevelopmental outcome.
UR - http://www.scopus.com/inward/record.url?scp=85141989656&partnerID=8YFLogxK
U2 - 10.1016/j.jpeds.2022.10.010
DO - 10.1016/j.jpeds.2022.10.010
M3 - Article
C2 - 36241053
SN - 0022-3476
VL - 254
SP - 25
EP - 32
JO - The Journal of Pediatrics
JF - The Journal of Pediatrics
ER -