Late morbidity during childhood and adolescence in previously premature neonates after patent ductus arteriosus closure
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Late morbidity during childhood and adolescence in previously premature neonates after patent ductus arteriosus closure. / Dodge-Khatami, Ali; Tschuppert, Scott; Latal, Bea; Rousson, Valentin; Doell, Carsten.
in: PEDIATR CARDIOL, Jahrgang 30, Nr. 6, 08.2009, S. 735-740.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Late morbidity during childhood and adolescence in previously premature neonates after patent ductus arteriosus closure
AU - Dodge-Khatami, Ali
AU - Tschuppert, Scott
AU - Latal, Bea
AU - Rousson, Valentin
AU - Doell, Carsten
PY - 2009/8
Y1 - 2009/8
N2 - The health status of previously premature neonates after closure of a patent ductus arteriosus (PDA) was analyzed in childhood and adolescence. Physician questionnaires were used to study 180 hospital survivors among 210 consecutive premature neonates who underwent PDA closure between 1985 and 2005. Complete follow-up data were obtained for 129 patients (72%). During a median follow-up period of 7 years (range, 2-22 years), three late deaths (2.3%) had occurred. Only 45% of the patients were considered healthy. Morbidity included developmental delay (41.1%), pulmonary illness (12.4%), neurologic impairment (14.7%), hearing impairment (3.9%), gastrointestinal disease (3.1%), and thoracic deformity (1.2%). None of the adverse variables during the neonatal period (intraventricular hemorrhage, bradycardia apnea syndrome, bronchopulmonary dysplasia, pulmonary bleeding, hyaline membrane disease, artificial respiration time [continuous positive airway pressure + intubation], or necrotizing enterocolitis) statistically predicted respective system morbidity at the follow-up evaluation. Hyaline membrane disease (odds ratio, 2.5; p = 0.026) and longer hospitalization time (odds ratio, 1.2 days per 10 hospitalization days; p = 0.032) in the newborn period were significant predictors of an unhealthy outcome at the last follow-up evaluation. Survival until childhood after closure of a hemodynamically significant PDA in premature neonates is satisfactory. However, physical and neurodevelopmental co-morbidity persist for half of the patients, perhaps as a sequela of prematurity unrelated to ductus closure.
AB - The health status of previously premature neonates after closure of a patent ductus arteriosus (PDA) was analyzed in childhood and adolescence. Physician questionnaires were used to study 180 hospital survivors among 210 consecutive premature neonates who underwent PDA closure between 1985 and 2005. Complete follow-up data were obtained for 129 patients (72%). During a median follow-up period of 7 years (range, 2-22 years), three late deaths (2.3%) had occurred. Only 45% of the patients were considered healthy. Morbidity included developmental delay (41.1%), pulmonary illness (12.4%), neurologic impairment (14.7%), hearing impairment (3.9%), gastrointestinal disease (3.1%), and thoracic deformity (1.2%). None of the adverse variables during the neonatal period (intraventricular hemorrhage, bradycardia apnea syndrome, bronchopulmonary dysplasia, pulmonary bleeding, hyaline membrane disease, artificial respiration time [continuous positive airway pressure + intubation], or necrotizing enterocolitis) statistically predicted respective system morbidity at the follow-up evaluation. Hyaline membrane disease (odds ratio, 2.5; p = 0.026) and longer hospitalization time (odds ratio, 1.2 days per 10 hospitalization days; p = 0.032) in the newborn period were significant predictors of an unhealthy outcome at the last follow-up evaluation. Survival until childhood after closure of a hemodynamically significant PDA in premature neonates is satisfactory. However, physical and neurodevelopmental co-morbidity persist for half of the patients, perhaps as a sequela of prematurity unrelated to ductus closure.
KW - Adolescent
KW - Cardiac Surgical Procedures/methods
KW - Child
KW - Child, Preschool
KW - Ductus Arteriosus, Patent/epidemiology
KW - Female
KW - Follow-Up Studies
KW - Health Status
KW - Humans
KW - Infant
KW - Infant, Newborn
KW - Infant, Premature
KW - Male
KW - Morbidity/trends
KW - Retrospective Studies
KW - Survivors/statistics & numerical data
KW - Switzerland/epidemiology
KW - Time Factors
KW - Treatment Outcome
U2 - 10.1007/s00246-009-9426-1
DO - 10.1007/s00246-009-9426-1
M3 - SCORING: Journal article
C2 - 19412564
VL - 30
SP - 735
EP - 740
JO - PEDIATR CARDIOL
JF - PEDIATR CARDIOL
SN - 0172-0643
IS - 6
ER -