• The Journal of pediatrics · Mar 2007

    Clinical Trial

    Neurosensory impairment after surgical closure of patent ductus arteriosus in extremely low birth weight infants: results from the Trial of Indomethacin Prophylaxis in Preterms.

    • Nandkishor S Kabra, Barbara Schmidt, Robin S Roberts, Lex W Doyle, Luann Papile, Avroy Fanaroff, and Trial of Indomethacin Prophylaxis in Preterms Investigators.
    • Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.
    • J. Pediatr. 2007 Mar 1;150(3):229-34, 234.e1.

    ObjectivesTo determine whether surgical closure of a patent ductus arteriosus (PDA) is a risk factor for bronchopulmonary dysplasia (BPD), severe retinopathy of prematurity (ROP), and neurosensory impairment in extremely low birth weight (ELBW) infants.Study DesignWe studied 426 infants with a symptomatic PDA, 110 of whom underwent PDA ligation and 316 of whom received medical therapy only. All infants participated in the multicenter Trial of Indomethacin Prophylaxis in Preterms (TIPP) and were observed to a corrected age of 18 months.ResultsOf the 95 infants who survived after PDA ligation, 50 (53%) had neurosensory impairment, compared with 84 of the 245 infants (34%) who survived after receiving only medical therapy (adjusted odds ratio, 1.98; 95% CI, 1.18-3.30; P = .0093). BPD (adjusted odds ratio, 1.81; 95% CI, 1.09-3.03; P = .023) and severe ROP (adjusted odds ratio, 2.20; 95% CI, 1.19-4.07; P = .012) were also more common after surgical PDA closure.ConclusionsPDA ligation may be associated with increased risks of BPD, severe ROP, and neurosensory impairment in ELBW infants.

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