Treatment of Patent Ductus Arteriosus Linked to Neurodevelopmental Risks in Infants

Prof. Abdel-Latif MohamedDiscipline of Neonatology, Medical School, College of Medicine, Biology & Environment Australian National University Acton, Canberra, ACT, AustraliaMedicalResearch.com Interview with:
Prof. Abdel-Latif Mohamed
Discipline of Neonatology,
Medical School, College of Medicine, Biology & Environment
Australian National University
Acton, Canberra, ACT, Australia

Medical Research: What is the background for this study?
What are the main findings?

Prof. Mohamed: Despite decades of research and debate amongst neonatologists, consensus regarding optimal management of Patent Ductus Arteriosus (PDA) in the premature infant is yet to be established. The vast majority of premature infants are treated with oral or intravenous medication and surgical ligation is usually reserved to severely ill infants.

Our study demonstrated that treatment for Patent Ductus Arteriosus , particularly of a surgical nature, maybe associated with a greater risk of adverse neurodevelopmental outcome at 2-3 years of age. This was particularly so among infants born below 25 weeks gestation. This result may support permissive tolerance of PDAs. However, reasons for this association remain to be elucidated through carefully designed prospective trials.

Medical Research: What should clinicians and parents take away from your report?

Prof. Mohamed: Overall, our results may support permissive tolerance of PDAs. Treatment of Patent Ductus Arteriosus should be individualised and decided on case by case basis. Treatment, particularly of a surgical nature, should not be rushed unless absolutely indicated.

Infants who undergo treatment for Patent Ductus Arteriosus should be monitored for early detection of neurodevelopmental abnormalities.

Medical Research: What recommendations do you have for future research as a result of this study?

Prof. Mohamed: Large-scale well-designed controlled trials will be necessary before consensus is reached and evidence-based guidelines can be produced on this subject. Such trials should focus on both short-term gains and long-term outcomes.

Citation:

J Pediatr. 2015 Jul 27. pii: S0022-3476(15)00692-7. doi: 10.1016/j.jpeds.2015.06.054. [Epub ahead of print]

Neurodevelopmental Outcomes of Premature Infants Treated for Patent Ductus Arteriosus: A Population-Based Cohort Study.

Janz-Robinson EM1, Badawi N2, Walker K2, Bajuk B3, Abdel-Latif ME4; Neonatal Intensive Care Units Network.

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Prof. Abdel-Latif Mohamed (2015). Treatment of Patent Ductus Arteriosus Linked to Neurodevelopmental Risks in Infants