Objective

Assess if unit-level PDA management correlates with neurodevelopmental impairment (NDI) at 18–24 months corrected postnatal age (CPA) 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 for 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.

Results

377 infants were evaluated. PDA treatment rates remained unchanged in Site 1 but eventually reached 0% in Site 2. Comparable rates of any/significant NDI were seen across both sites (any NDI: 38% vs 36%; significant NDI: 13% vs 10% for Site 1 and 2, respectively). After adjustments, NDI rates remained similar.

Conclusion

PDA management strategies in extremely preterm newborns showed no significant impact on neurodevelopment outcomes at 18–24 months CPA.

中文翻译：

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评估动脉导管未闭入路与极早产儿神经发育之间的关系

客观的

评估单元级 PDA 管理是否与极早产儿 18-24 个月校正产后年龄 (CPA) 的神经发育障碍 (NDI) 相关。

学习规划

对具有不同 PDA 策略的两个单位的 <29 周（2014-2017）出生婴儿进行回顾性分析。站点 1 采用基于超声心动图的治疗策略，旨在加速闭合（对照）。站点 2 采取了保守的方法。主要终点：NDI，其特征为脑瘫、Bayley-III 综合评分<85、感音神经性/混合性听力损失或至少单侧视力障碍。

结果

377 名婴儿接受了评估。站点 1 中的 PDA 治疗率保持不变，但最终在站点 2 中达到 0%。两个站点中任何/显着 NDI 的发生率相当（任何 NDI：38% vs 36%；显着 NDI：站点 1 为 13% vs 10%）和 2）。调整后，NDI 比率保持相似。

结论

极早产新生儿的 PDA 管理策略对 18-24 个月 CPA 时的神经发育结果没有显着影响。