Late morbidity during childhood and adolescence in previously premature neonates after patent ductus arteriosus closure

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 -