Comparison of neurodevelopmental outcomes of extremely preterm infants undergoing trans-catheter closure of the patent ductus arteriosus compared to surgical ligation

比较极早产儿经导管动脉导管未闭封堵术与外科手术结扎术后的神经发育结局

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Abstract

BACKGROUND: There is a paucity of data on neurodevelopmental outcomes in preterm infants who undergo transcatheter patent ductus arteriosus (PDA) closure (TCPC). OBJECTIVE: To evaluate neurodevelopmental impairment (NDI) or death at 2 years among preterm infants treated with TCPC compared to surgical ligation. METHODS: Retrospective cohort study of infants born at <27 weeks' gestation at NICHD NRN sites. Comparisons were made between infants who underwent TCPC and PDA ligation. RESULTS: TCPC and surgical ligation were performed on 99 and 279 infants, respectively. Death or severe NDI occurred in 49% of infants with TCPC and 40% with surgical ligation. There was no difference in odds of death or severe NDI between the two groups [aOR 1.12 95% CI: 0.55-2.26)]. CONCLUSION: TCPC had similar odds of death or severe NDI compared to surgical ligation. These findings need to be evaluated in large prospective studies as the management practice around the TCPC evolves. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov ID: Generic Database: NCT00063063.

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