The Timing of Surgical Ligation for Patent Ductus Arteriosus Is Associated with Neonatal Morbidity in Extremely Preterm Infants Born at 23-25 Weeks of Gestation.
10.3346/jkms.2014.29.4.581
- Author:
Se In SUNG
1
;
Soo Young CHOI
;
Jae Hyun PARK
;
Myung Sook LEE
;
Hye Soo YOO
;
So Yoon AHN
;
Yun Sil CHANG
;
Won Soon PARK
Author Information
1. Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea. wonspark@skku.edu
- Publication Type:Original Article
- Keywords:
Ductus Arteriosus, Patent;
Ligation;
Indomethacin;
Ibuprofen
- MeSH:
Adult;
Birth Weight;
Demography;
Ductus Arteriosus, Patent/diagnosis/epidemiology/*surgery;
Female;
Gestational Age;
Humans;
Infant, Extremely Premature;
Infant, Newborn;
Logistic Models;
Male;
Odds Ratio;
Prognosis;
Retrospective Studies;
Time Factors
- From:Journal of Korean Medical Science
2014;29(4):581-586
- CountryRepublic of Korea
- Language:English
-
Abstract:
The purpose of this study was to evaluate prognostic factors associated with surgical ligation for patent ductus arteriosus (PDA) in extremely preterm infants born at the limits of viability. Ninety infants who were born at 23-25 weeks of gestation and who received surgical ligation were included and their cases were retrospectively reviewed. Infants were classified into two different groups: survivors with no major morbidity (N), and non-survivors or survivors with any major morbidity (M). Clinical characteristics were compared between the groups. Possible prognostic factors were derived from this comparison and further tested by logistic regression analysis. The mean gestational age and the mean birth weight of M were significantly lower than those of N. Notably, the mean postnatal age at time of ligation in N was significantly later than that of the other group (17+/-12 vs 11+/-8 days in N and M, respectively). An adjusted analysis showed that delayed ligation (>2 weeks) was uniquely associated with a significantly decreased risk for mortality or composite morbidity after surgical ligation (OR, 0.105; 95% CI, 0.012-0.928). In conclusion, delayed surgical ligation for PDA (>2 weeks) is associated with decreased mortality or morbidities in extremely preterm infants born at 23-25 weeks of gestation.
