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KMID : 1130320080510101065
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Korean Journal of Pediatrics
2008 Volume.51 No. 10 p.1065 ~ p.1070
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Delayed closure effect in preterm infants with patent ductus arteriosus
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Lee Hyun-Ju
Shim Gyu-Hong
Joung Kyoung-Eun
Lee Jin-A
Chol Chang-Won
Kim Ee-Kyung
Kim Han-Suk
Kim Beyong-Il
Choi Jung-Hwan
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Abstract
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Purpose : This study aims to determine whether early closure (within 7 d) of significant patent ductus arteriosus (PDA) with indomethacin or ligation reduces neonatal morbidity when compared with delayed closure (after 7 d).
Methods : Fifty-eight extremely-low-birth-weight infants admitted to the NICU of Seoul National University Hospital from April 2005 to May 2007 with PDA were studied retrospectively.
Results : The mean gestational age (GA) was 26±2 weeks (range, 23-32 wk), and the birth weight was 782±146 g (range, 430-990 g). The delayed closure group was associated with early GA (25.7±1.7 wk vs. 27.1±2.0 wk, P=0.013), in vitro fertilization (IVF) (55% vs 24%, P=0.017), and the absence of preeclampsia (5% vs. 34%, P=0.013). There was no difference in ductal size between the early closure and delayed closure groups. The incidence of bronchopulmonary dysplasia (95% vs 65%, P=0.012) and intraventricular hemorrhage (70% vs. 39%, P=0.027) increased in the delayed closure group. Using regression analysis adjusted for gestational age, delayed closure correlated positively with the duration of ventilator support (P=0.008), hospitalization (P=0.020), time to full enteral feeding (P<0.001), and total parenteral nutrition (P=0.010)..
Conclusion : Delayed closure of the hemodynamically significant patent ductus arteriosus in extremely-low-birth-weight infants is significantly related to the development of various morbidities. Thus, early closure of PDA is needed within the first week of life.
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KEYWORD
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Patent ductus arteriosus, Prematurity, Indomethacin, Surgical procedures, Treatment
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