Neurosensory impairment after surgical closure of patent ductus arteriosus in extremely low birth weight infants: Results from the trial of indomethacin prophylaxis in preterms
Neurosensory impairment after surgical closure of patent ductus arteriosus in extremely low birth weight infants: Results from the trial of indomethacin prophylaxis in preterms
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DOI：
10.1016/j.jpeds.2006.11.039
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发表时间：
2007-03-01
影响因子：
5.1
通讯作者：
Fanaroff, Avroy
中科院分区：
文献类型：
--
作者：
Kabra, Nandkishor S.;Schmidt, Barbara;Fanaroff, Avroy
目的：为了确定是否手术闭合动脉导管未闭（PDA）是支气管肺发育不良（BPD），严重的早产儿视网膜病变（ROP）和神经感觉功能障碍的危险因素，在极低出生体重（ELBW）infants.Study design：我们研究了426名婴儿有症状的PDA，其中110人接受PDA结扎和316人只接受药物治疗。结果：95例PDA结扎后存活的婴儿中，50例（53%）有感觉神经功能障碍，245例仅接受药物治疗的婴儿中，84例（34%）有感觉神经功能障碍（调整后比值比，1.98; 95% CI，1.18-3.30; P = .0093）。BPD（调整后的比值比，1.81，95%CI，1.09-3.03; P = .023）和严重ROP（调整后的比值比，2.20; 95%CI，1.19-4.07; P = .012）也更常见于手术PDA closed.Conclusions：PDA结扎可能与BPD，严重ROP和神经感觉功能障碍的风险增加ELBW婴儿。
Objectives: To 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 design: We 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.Results: Of 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.Conclusions: PDA ligation may be associated with increased risks of BPD, severe ROP, and neurosensory impairment in ELBW infants.