The ductus arteriosus rarely requires treatment in infants > 1000 grams

Sheri L. Nemerofsky, Elvira Parravicini, David Bateman, Charles Kleinman, Richard A. Polin, John M. Lorenz

Research output: Contribution to journalArticle

68 Citations (Scopus)

Abstract

We sought to determine the rate of spontaneous closure of the ductus arteriosus (DA) in very-low-birth-weight infants. This prospective observational study included 65 infants whose birth weight (BW) <1500 g. Echocardiograms were done on day of life (DOL) 3 and 7, weekly for the first month, and bimonthly until ligation, discharge, or death. Treatment was reserved for infants with heart failure, acute renal impairment, or those with significant persistent or escalating respiratory support. Chi-square tests, Student t tests, and logistic regression models were used to identify possible associations between spontaneous ductal closure by DOL 7 and predictor variables. Patterns of spontaneous DA closure over time were examined using Kaplan-Meier survival analysis. The DA closed spontaneously in 49% infants by DOL 7. Rates of spontaneous closure by DOL 7 differed significantly by BW strata: 67% for BW >1000 g, 31% for BW ≤1000 g (p<0.01). Ninety-seven percent of infants >1000 g did not require intervention, and the DA closed spontaneously prior to discharge in 94%. In a logistic regression model, only BW > 1000 g and male gender were significantly associated with spontaneous closure by 1 week of life. The median time to spontaneous closure differed significantly between infants in the two BWstrata: 7 days for >1000 g versus 56 days for ≤1000 g (p<0.001). Intervention for the patent DA in infants >1000 g BW is rarely indicated. In infants ≤1000 g BW, deferring treatment decisions until at least 1 week of life may avoid unnecessary treatment exposure.

Original languageEnglish (US)
Pages (from-to)661-666
Number of pages6
JournalAmerican Journal of Perinatology
Volume25
Issue number10
DOIs
StatePublished - Nov 2008

Fingerprint

Ductus Arteriosus
Birth Weight
Logistic Models
Therapeutics
Very Low Birth Weight Infant
Observational Studies
Prospective Studies

Keywords

  • Ductus arteriosus
  • Indomethacin
  • Ligation
  • Prematurity

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

The ductus arteriosus rarely requires treatment in infants > 1000 grams. / Nemerofsky, Sheri L.; Parravicini, Elvira; Bateman, David; Kleinman, Charles; Polin, Richard A.; Lorenz, John M.

In: American Journal of Perinatology, Vol. 25, No. 10, 11.2008, p. 661-666.

Research output: Contribution to journalArticle

Nemerofsky, SL, Parravicini, E, Bateman, D, Kleinman, C, Polin, RA & Lorenz, JM 2008, 'The ductus arteriosus rarely requires treatment in infants > 1000 grams', American Journal of Perinatology, vol. 25, no. 10, pp. 661-666. https://doi.org/10.1055/s-0028-1090594
Nemerofsky, Sheri L. ; Parravicini, Elvira ; Bateman, David ; Kleinman, Charles ; Polin, Richard A. ; Lorenz, John M. / The ductus arteriosus rarely requires treatment in infants > 1000 grams. In: American Journal of Perinatology. 2008 ; Vol. 25, No. 10. pp. 661-666.
@article{970fa740ac734b60a102e7a77a4af5a9,
title = "The ductus arteriosus rarely requires treatment in infants > 1000 grams",
abstract = "We sought to determine the rate of spontaneous closure of the ductus arteriosus (DA) in very-low-birth-weight infants. This prospective observational study included 65 infants whose birth weight (BW) <1500 g. Echocardiograms were done on day of life (DOL) 3 and 7, weekly for the first month, and bimonthly until ligation, discharge, or death. Treatment was reserved for infants with heart failure, acute renal impairment, or those with significant persistent or escalating respiratory support. Chi-square tests, Student t tests, and logistic regression models were used to identify possible associations between spontaneous ductal closure by DOL 7 and predictor variables. Patterns of spontaneous DA closure over time were examined using Kaplan-Meier survival analysis. The DA closed spontaneously in 49{\%} infants by DOL 7. Rates of spontaneous closure by DOL 7 differed significantly by BW strata: 67{\%} for BW >1000 g, 31{\%} for BW ≤1000 g (p<0.01). Ninety-seven percent of infants >1000 g did not require intervention, and the DA closed spontaneously prior to discharge in 94{\%}. In a logistic regression model, only BW > 1000 g and male gender were significantly associated with spontaneous closure by 1 week of life. The median time to spontaneous closure differed significantly between infants in the two BWstrata: 7 days for >1000 g versus 56 days for ≤1000 g (p<0.001). Intervention for the patent DA in infants >1000 g BW is rarely indicated. In infants ≤1000 g BW, deferring treatment decisions until at least 1 week of life may avoid unnecessary treatment exposure.",
keywords = "Ductus arteriosus, Indomethacin, Ligation, Prematurity",
author = "Nemerofsky, {Sheri L.} and Elvira Parravicini and David Bateman and Charles Kleinman and Polin, {Richard A.} and Lorenz, {John M.}",
year = "2008",
month = "11",
doi = "10.1055/s-0028-1090594",
language = "English (US)",
volume = "25",
pages = "661--666",
journal = "American Journal of Perinatology",
issn = "0735-1631",
publisher = "Thieme Medical Publishers",
number = "10",

}

TY - JOUR

T1 - The ductus arteriosus rarely requires treatment in infants > 1000 grams

AU - Nemerofsky, Sheri L.

AU - Parravicini, Elvira

AU - Bateman, David

AU - Kleinman, Charles

AU - Polin, Richard A.

AU - Lorenz, John M.

PY - 2008/11

Y1 - 2008/11

N2 - We sought to determine the rate of spontaneous closure of the ductus arteriosus (DA) in very-low-birth-weight infants. This prospective observational study included 65 infants whose birth weight (BW) <1500 g. Echocardiograms were done on day of life (DOL) 3 and 7, weekly for the first month, and bimonthly until ligation, discharge, or death. Treatment was reserved for infants with heart failure, acute renal impairment, or those with significant persistent or escalating respiratory support. Chi-square tests, Student t tests, and logistic regression models were used to identify possible associations between spontaneous ductal closure by DOL 7 and predictor variables. Patterns of spontaneous DA closure over time were examined using Kaplan-Meier survival analysis. The DA closed spontaneously in 49% infants by DOL 7. Rates of spontaneous closure by DOL 7 differed significantly by BW strata: 67% for BW >1000 g, 31% for BW ≤1000 g (p<0.01). Ninety-seven percent of infants >1000 g did not require intervention, and the DA closed spontaneously prior to discharge in 94%. In a logistic regression model, only BW > 1000 g and male gender were significantly associated with spontaneous closure by 1 week of life. The median time to spontaneous closure differed significantly between infants in the two BWstrata: 7 days for >1000 g versus 56 days for ≤1000 g (p<0.001). Intervention for the patent DA in infants >1000 g BW is rarely indicated. In infants ≤1000 g BW, deferring treatment decisions until at least 1 week of life may avoid unnecessary treatment exposure.

AB - We sought to determine the rate of spontaneous closure of the ductus arteriosus (DA) in very-low-birth-weight infants. This prospective observational study included 65 infants whose birth weight (BW) <1500 g. Echocardiograms were done on day of life (DOL) 3 and 7, weekly for the first month, and bimonthly until ligation, discharge, or death. Treatment was reserved for infants with heart failure, acute renal impairment, or those with significant persistent or escalating respiratory support. Chi-square tests, Student t tests, and logistic regression models were used to identify possible associations between spontaneous ductal closure by DOL 7 and predictor variables. Patterns of spontaneous DA closure over time were examined using Kaplan-Meier survival analysis. The DA closed spontaneously in 49% infants by DOL 7. Rates of spontaneous closure by DOL 7 differed significantly by BW strata: 67% for BW >1000 g, 31% for BW ≤1000 g (p<0.01). Ninety-seven percent of infants >1000 g did not require intervention, and the DA closed spontaneously prior to discharge in 94%. In a logistic regression model, only BW > 1000 g and male gender were significantly associated with spontaneous closure by 1 week of life. The median time to spontaneous closure differed significantly between infants in the two BWstrata: 7 days for >1000 g versus 56 days for ≤1000 g (p<0.001). Intervention for the patent DA in infants >1000 g BW is rarely indicated. In infants ≤1000 g BW, deferring treatment decisions until at least 1 week of life may avoid unnecessary treatment exposure.

KW - Ductus arteriosus

KW - Indomethacin

KW - Ligation

KW - Prematurity

UR - http://www.scopus.com/inward/record.url?scp=57149112518&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=57149112518&partnerID=8YFLogxK

U2 - 10.1055/s-0028-1090594

DO - 10.1055/s-0028-1090594

M3 - Article

VL - 25

SP - 661

EP - 666

JO - American Journal of Perinatology

JF - American Journal of Perinatology

SN - 0735-1631

IS - 10

ER -