Evaluation of the association between patent ductus arteriosus approach and neurodevelopment in extremely preterm infants

Abstract

Assess if unit-level PDA management correlates with neurodevelopmental impairment (NDI) at 18-24 months corrected gestational age (cGA) in extremely preterm infants. Study design:Retrospective analysis of infants born at < 29 weeks (2014-2017) across two units having distinct PDA strategies. Site 1 utilized an echocardiography-based treatment strategy aiming accelerated closure (control). Site 2 followed a conservative approach. Primary endpoint: NDI, characterized by cerebral palsy, any Bayley-III composite score < 85, sensorineural/mixed hearing loss, or at least unilateral visual impairment. Results377 infants were evaluated. PDA treatment rates remained unchanged in Site 1 but eventually reached 0% in Site 2. Comparable rates of any/signi cant NDI were seen across both sites (any NDI: 38% vs 36%; signi cant NDI: 13% vs 10% for Site 1 and 2, respectively). After adjustments, NDI rates remained similar. ConclusionPDA management strategies in extremely preterm newborns showed no signi cant impact on neurodevelopment outcomes at 18-24 months cGA. **Adjusted for bronchopulmonary dysplasia, chorioamnionitis, gestational age at birth and signi cant intraventricular hemorrhage (grade 3 or 4, or presence of periventricular leukomalacia).Abbreviations: Gross Motor Function Classi cation System (GMFCS).