The Impact Of Persistent PAD On Growth Development And Neurodevelopment In Very Low Birth Weight Premature Infants

Objective. To examine the affects of persistent patent ductusarteriosus (pPDA) on the outcome of growth and neurodevelopment in verylow birth weight (VLBW) infants.To determine the incidence of spontaneousclosure of PDA among these infants with ductal patency at the time ofinitial hospital discharge.Method. This was a single-center, cohort study. A total of147VLBWswhose gestational age below34weeks were recruited. All neonates wereroutinely screened with echocardiography for PDA on day of life（DOL）2~5but only infants with a symptomatic PDA received COX inhibitor to closethe PDA. Two groups were defined: a pPDA group whose DA patent DOL10~14,and a no pPDA group either whose DA closed within DOL10~14or withoutPDA. The outcomes of mortality and mobidity,growth development andneurodevelopment were compared，states of persistent patent ductusarteriosu after discharge were observed.Result. Patients with pPDA (n=36，GA29.78±1.64W，BW1.23±0.19kg) hadstatistical lower gestational age and birth weight but larger ductusdiameter（0.203±0.05cm；0.171±0.06cm） than those without (n=111，GA30.44±1.64W，BW1.28±0.15kg). Compared to those without pPDA，VLBWswith persistent PDA had higher incidence of death and pulmonaryhaemorrhage、BPD、NEC、grade Ⅲ~Ⅳ IVH，（RR respectively3.85、15.42、3.98、3.08、5.14），as well as the higher Hospitalization costs and longerhospital stays。However，no statistical difference were found in the rateof ROP and PVL。Ther were no statistical difference of length/weight/head circumference-Zscore and DQ between two grops. Incidence of spontaneousclosure of PDA after discharge were up to85.7%。Conclusion. persistent PDA was associated with lower gestationalage and birth weight,mobidatity and motality but growth andneurodevelopment outcome. Incidence of spontaneous closure of PDA afterdischarge were so high that rarely requaring ligation.