Patent ductus arteriosus and small for gestational age infants: Treatment approaches and outcomes. (April 2019)

• Record Type: Journal Article
• Authors: Aldana-Aguirre, Jose Carlos; Toye, Jennifer; Shah, Prakesh S.; Yoon, Eugene W.; Kumaran, Kumar
• Is Part Of: Early human development. Volume 131(2019)
• Page Start: 10
• Page End: 14
• Publication Date: 2019-04
• Subjects: Premature infants -- Patent ductus arteriosus -- Small for gestational age -- Appropriate for gestational age; Fetus -- Periodicals; Neonatology -- Periodicals; Prenatal influences -- Periodicals; 612.65
• DOI: 10.1016/j.earlhumdev.2019.02.002
• Languages: English
• ISSNs: 0378-3782

Abstract

Abstract: Background: The current treatment approach in patent ductus arteriosus suggests the identification of high-risk infants that may benefit the most from treatment. Small for gestational age infants are a high-risk population in which the treatment approach to the patent ductus arteriosus and outcomes have not been described. Aim: To compare the patent ductus arteriosus treatment approach and outcomes in small for gestational age and appropriate for gestational age infants. Study design: Retrospective analysis of infants born between January 1, 2011 and December 31, 2015 at <33 weeks' GA and admitted to neonatal intensive care units (NICU) part of the Canadian Neonatal Network. Results: 595 of 2507 small for gestational age infants (23.7%) and 4714 of 20, 002 appropriate for gestational age infants (23.6%) had a patent ductus arteriosus. The patent ductus arteriosus treatment approach (conservative, medical, surgical) was similar in both groups. Small for gestational age infants with and without a patent ductus arteriosus had increased risk of the composite outcome of death or bronchopulmonary dysplasia (aOR 3.40; 95% CI 2.73, 4.24; and aOR 2.72; 95% CI 2.24, 3.31) respectively. Conclusions: Patent ductus arteriosus management did not differ between small for gestational age and appropriate for gestational age infants. Small for gestational age infants had increased risk of death or bronchopulmonary dysplasia regardless of their patent ductus arteriosus status. Highlights: Small for gestational age infants are a high-risk population for adverse neonatal outcomes. Treatment approach to the patent ductus arteriosus in small for gestational age infants had not been reported. In our study the treatment approach to patent ductus arteriosus did not differ among small and appropriate for gestational age infants. Small for gestational age infants were at higher risk for death or bronchopulmonary dysplasia than appropriate for gestational age infants regardless of their ductal status.