Voice and Exercise Related Respiratory Symptoms in Extremely Preterm Born Children After Neonatal Patent Ductus Arteriosus

Abstract

Objective: To investigate voice characteristics and exercise related respiratory symptoms in extremely preterm born 11-year-old children, focusing particularly on associations with management of a patent ductus arteriosus (PDA). Study design: Prospective follow-up of all children born in Norway during 1999-2000 at gestational age <28 weeks or with birthweight <1,000 g. Neonatal data were obtained prospectively on custom-made registration forms completed by neonatologists. Voice characteristics and exercise related respiratory symptoms were obtained at 11 years by parental questionnaires. Result: Questionnaires were returned for 228/372 (61%) eligible children, of whom 137 had no history of PDA. PDA had been noted in 91 participants, of whom 36 had been treated conservatively, 21 with indomethacin, and 34 with surgery. Compared to the children treated with indomethacin or conservatively, the odds ratio (95% confidence interval) for the surgically treated children were 3.4 (1.3; 9.2) for having breathing problems during exercise, 16.9 (2.0; 143.0) for having a hoarse voice, 4.7 (1.3; 16.7) for a voice that breaks when shouting, 4.6 (1.1; 19.1) for a voice that disturbs singing, and 3.7 (1.1; 12.3) for problems shouting or speaking loudly. The significance of surgery per se was uncertain since the duration of mechanical ventilation was associated with the same outcomes. Conclusion: Extremely preterm born children with a neonatal history of PDA surgery had more problems with voice and breathing during exercise in mid-childhood than those whose PDA had been handled otherwise. The study underlines the causal heterogeneity of exercise related respiratory symptoms in preterm born children.

Neurodevelopmental disorders and somatic diagnoses in a national cohort of children born before 24 weeks of gestation

“…5,6,37 More than half of all children (52%) in our study had been diagnosed with speech disorders, including impaired articulation and language development, and 13% had vocal cord paresis, which may impact both their voice and their respiration. 38 It is challenging to achieve optimal growth in those born EPT during the neonatal period and childhood. One study reported that children who were born EPT demonstrated catch-up growth in weight and length during childhood, but not head circumference.…”

“…More than half of all children (52%) in our study had been diagnosed with speech disorders, including impaired articulation and language development, and 13% had vocal cord paresis, which may impact both their voice and their respiration. 38 …”

Sex Differences in Patent Ductus Arteriosus Incidence and Response to Pharmacological Treatment in Preterm Infants: A Systematic Review, Meta-Analysis and Meta-Regression

“…The flow diagram of the search process is shown in Figure S1 . Of 2130 potentially relevant studies, 146 (including 357,781 infants) were included [ 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 ,…”

Retrospective comparison of death or neurodevelopmental outcomes in extremely low birth weight preterm infants following different management options of haemodynamically significant patent ductus arteriosus

“…In preterm infants, the closure is often delayed due to a lower intrinsic tone of the ductus and increased ductus sensitivity to the vasodilating effects of prostaglandin E2 and nitric oxide (NO) [ 1 ]. There is an inverse relationship between the rate of ductal closure and the birth weight (BW) and gestational age (GA) [ 2 – 5 ].…”