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Natural evolution of the patent ductus arteriosus in the extremely premature newborn and respiratory outcomes

Journal of Perinatology volume 42, pages 642–648 (2022)Cite this article

Subjects

Abstract

Objective

Evaluate spontaneous closure of the patent ductus arteriosus (PDA) in extremely preterm infants and their respiratory outcomes, especially at <26 weeks gestational age (GA).

Study design

Retrospective study in <29 weeks, admitted within 24 h after birth (Feb 2015 and Dec 2019). Infants without any intervention to promote ductal closure, ≥1 echocardiography, and alive at discharge were included.

Results

Two hundred and fourteen infants (average GA 26.3 ± 1.5 weeks) were included; 84 (39%) <26 weeks. PDA closed spontaneously in 194 (91%); 76/84 (90%) for infants <26 weeks. PDA closure was ascertained on an echocardiography performed at a median age of 36.4 [34.4–40.1] weeks. Rate of moderate-to-severe bronchopulmonary dysplasia decreased throughout the study period (OR for year of birth: 0.70 [95% CI: 0.57–0.87], p = 0.001).

Conclusion

Majority of extremely preterm infants, including <26 weeks, had spontaneous closure of the ductus before term corrected age. There was a concomitant improvement of respiratory outcomes.

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Fig. 1: Flow diagram for patient inclusion.

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Acknowledgements

We acknowledge the support of the Canadian Neonatal Network who provided the local data for our center.

Funding

This work was supported by the Department of Pediatrics of the MUHC (Pilot Grant), by Just for Kids Foundation and the Montreal Children’s Hospital Foundation. The funder/sponsor did not participate in the work.

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Authors and Affiliations

  1. Neonatology—McGill University Health Centre—Montreal Children’s Hospital, Department of Pediatrics, McGill University, Montreal, QC, Canada

    Gabriela de Carvalho Nunes, Punnanee Wutthigate, Jessica Simoneau, Marc Beltempo, Guilherme Mendes Sant’Anna & Gabriel Altit

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  1. Gabriela de Carvalho Nunes
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  6. Gabriel Altit
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Contributions

GdCN conceptualized and designed the study, collected the data, analyzed the data, drafted the paper, and adjusted the paper according to the comments of co-authors. PW and JS collected the data and revised the paper. MB conceptualized and designed the study, collected the data, critically appraised the analysis of the data and reviewed and revised the paper. GMSA critically appraised the analysis of the data, reviewed, and revised the paper. GA conceptualized and designed the study, supervised data collection, critically appraised the analysis of the data, wrote, and critically reviewed the paper for important intellectual content. All authors approved the final paper as submitted and agree to be accountable for all aspects of the work.

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Correspondence to Gabriel Altit.

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The authors declare no competing interests.

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The study was performed in accordance with the Declaration of Helsinki and was approved by the McGill University Health Center research ethics boards.

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de Carvalho Nunes, G., Wutthigate, P., Simoneau, J. et al. Natural evolution of the patent ductus arteriosus in the extremely premature newborn and respiratory outcomes. J Perinatol 42, 642–648 (2022). https://doi.org/10.1038/s41372-021-01277-2

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