Photo Credit: Brownie Harris

The following is a summary of “Changes in Patent Ductus Arteriosus Management and Outcomes in Infants Born at 26 to 28 Weeks’ Gestation,” published in the December 2024 issue of Pediatrics by Kaluarachchi et al.

Patent ductus arteriosus (PDA) treatment practices have changed over time, which may have affected outcomes for infants born at 26 to 28 weeks of gestation.  

Researchers conducted a retrospective study to investigate how changes in treatment for preterm infants with PDA affected the health outcomes.  

They involved 7,864 infants born at 26 0/7 to 28 6/7 weeks of gestation (2012-2021). The primary composite outcome was defined as surgical necrotizing enterocolitis (NEC), grade 2-3 bronchopulmonary dysplasia (BPD), severe intraventricular hemorrhage (IVH), or death. Multi-level modeling adjusted for patient-level factors was used to analyze the temporal trends in PDA treatment and outcomes, with a stratified analysis based on hospital changes in PDA management.  

The results showed a decrease in PDA treatment from 21% to 16% (P<0.01) and an increase in the primary composite outcome from 24% to 36% (P<0.01). This increase was driven by higher rates of grade 2-3 BPD, which rose from 13% to 26% (P<0.01), with most of the increase due to grade 2 BPD (10% to 22%, P<0.01). Temporal decreases in PDA treatment were associated with higher primary composite outcomes and grade 2-3 BPD after adjusting for patient-level factors (P<0.01). Increased grade 2-3 BPD was observed in all hospital groups, regardless of changes in PDA management.  

They concluded that decreases in PDA treatment were associated with increased rates of grade 2-3 BPD, but causality remains unclear, and further investigation is needed.  

Source: jpeds.com/article/S0022-3476(24)00559-6/abstract