Clinical outcomes of different patent ductus arteriosus treatment in preterm infants born between 28 and 32 weeks in Taiwan
Background: The patent ductus arteriosus (PDA) treatment in very preterm infants is controversial. This study focused on preterm infants born at 28–32 weeks of gestation and analyzed the association between various PDA treatments and clinical outcomes. Methods: We conducted a retrospective cohort st...
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Elsevier
2023-07-01
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| Series: | Pediatrics and Neonatology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1875957222002741 |
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| author | Hao-Wei Chung Shu-Ting Yang Fu-Wen Liang Hsiu-Lin Chen |
| author_facet | Hao-Wei Chung Shu-Ting Yang Fu-Wen Liang Hsiu-Lin Chen |
| author_sort | Hao-Wei Chung |
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| description | Background: The patent ductus arteriosus (PDA) treatment in very preterm infants is controversial. This study focused on preterm infants born at 28–32 weeks of gestation and analyzed the association between various PDA treatments and clinical outcomes. Methods: We conducted a retrospective cohort study of infants born at 28–32 weeks of gestation between 2016 and 2019 at 22 hospitals in the Taiwan Premature Infant Follow-up Network. We categorized the infants into four groups according to treatment strategies: medication, primary surgery, medication plus surgery, or conservative treatment. Results: A total of 1244 infants presented with PDA, and 761 (61.1%) were treated. Medication was the predominant treatment (50.0%), followed by conservative treatment (38.9%), medication plus surgery (7.6%), and primary surgery (3.5%). The risk of mortality was not reduced in the active treatment group compared to the conservative treatment group. There was a higher prevalence of severe intraventricular hemorrhage, necrotizing enterocolitis (NEC), and any degree of bronchopulmonary dysplasia (BPD) in both the primary surgery and medication plus surgery groups than in the conservative treatment group. After adjustment, both the primary surgery and medication plus surgery groups still had higher odds ratios for the occurrence of NEC and any degree of BPD. Conclusions: Compared with active PDA treatment, conservative treatment for PDA did not increase the risk of mortality and morbidity in very preterm infants born at 28–32 weeks of gestation. The risks and benefits of surgery (PDA ligation) in these infants must be considered cautiously. |
| format | Article |
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| institution | OA Journals |
| issn | 1875-9572 |
| language | English |
| publishDate | 2023-07-01 |
| publisher | Elsevier |
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| series | Pediatrics and Neonatology |
| spelling | doaj-art-9e1eb21f79004c03b903ea86b84b28cc2025-08-20T02:20:30ZengElsevierPediatrics and Neonatology1875-95722023-07-0164441141910.1016/j.pedneo.2022.12.004Clinical outcomes of different patent ductus arteriosus treatment in preterm infants born between 28 and 32 weeks in TaiwanHao-Wei Chung0Shu-Ting Yang1Fu-Wen Liang2Hsiu-Lin Chen3Department of Pediatrics, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Biological Science and Technology, National Yang Ming Chiao-Tung University, Hsinchu, Taiwan; Department of Pediatrics, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, TaiwanDivision of Neonatology, Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, TaiwanDepartment of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Center for Big Data Research, Kaohsiung Medical University, Kaohsiung, TaiwanDivision of Neonatology, Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Respiratory Therapy, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Corresponding author. Division of Neonatology, Department of Pediatrics, Kaohsiung Medical University Hospital,100, TzYou 1st Rd., Kaohsiung City 80756, Taiwan.Background: The patent ductus arteriosus (PDA) treatment in very preterm infants is controversial. This study focused on preterm infants born at 28–32 weeks of gestation and analyzed the association between various PDA treatments and clinical outcomes. Methods: We conducted a retrospective cohort study of infants born at 28–32 weeks of gestation between 2016 and 2019 at 22 hospitals in the Taiwan Premature Infant Follow-up Network. We categorized the infants into four groups according to treatment strategies: medication, primary surgery, medication plus surgery, or conservative treatment. Results: A total of 1244 infants presented with PDA, and 761 (61.1%) were treated. Medication was the predominant treatment (50.0%), followed by conservative treatment (38.9%), medication plus surgery (7.6%), and primary surgery (3.5%). The risk of mortality was not reduced in the active treatment group compared to the conservative treatment group. There was a higher prevalence of severe intraventricular hemorrhage, necrotizing enterocolitis (NEC), and any degree of bronchopulmonary dysplasia (BPD) in both the primary surgery and medication plus surgery groups than in the conservative treatment group. After adjustment, both the primary surgery and medication plus surgery groups still had higher odds ratios for the occurrence of NEC and any degree of BPD. Conclusions: Compared with active PDA treatment, conservative treatment for PDA did not increase the risk of mortality and morbidity in very preterm infants born at 28–32 weeks of gestation. The risks and benefits of surgery (PDA ligation) in these infants must be considered cautiously.http://www.sciencedirect.com/science/article/pii/S1875957222002741bronchopulmonary dysplasiaconservative treatmentnecrotizing enterocolitispatent ductus arteriosus treatmentpreterm infant |
| spellingShingle | Hao-Wei Chung Shu-Ting Yang Fu-Wen Liang Hsiu-Lin Chen Clinical outcomes of different patent ductus arteriosus treatment in preterm infants born between 28 and 32 weeks in Taiwan Pediatrics and Neonatology bronchopulmonary dysplasia conservative treatment necrotizing enterocolitis patent ductus arteriosus treatment preterm infant |
| title | Clinical outcomes of different patent ductus arteriosus treatment in preterm infants born between 28 and 32 weeks in Taiwan |
| title_full | Clinical outcomes of different patent ductus arteriosus treatment in preterm infants born between 28 and 32 weeks in Taiwan |
| title_fullStr | Clinical outcomes of different patent ductus arteriosus treatment in preterm infants born between 28 and 32 weeks in Taiwan |
| title_full_unstemmed | Clinical outcomes of different patent ductus arteriosus treatment in preterm infants born between 28 and 32 weeks in Taiwan |
| title_short | Clinical outcomes of different patent ductus arteriosus treatment in preterm infants born between 28 and 32 weeks in Taiwan |
| title_sort | clinical outcomes of different patent ductus arteriosus treatment in preterm infants born between 28 and 32 weeks in taiwan |
| topic | bronchopulmonary dysplasia conservative treatment necrotizing enterocolitis patent ductus arteriosus treatment preterm infant |
| url | http://www.sciencedirect.com/science/article/pii/S1875957222002741 |
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