Neonatal Intensive Care Unit-Level Patent Ductus Arteriosus Treatment Rates and Outcomes in Infants Born Extremely Preterm

The Journal of Pediatrics
Tetsuya IsayamaInternational Network for Evaluating Outcomes of Neonates (iNeo) Investigators

Abstract

To assess associations between neonatal intensive care unit (NICU)-level patent ductus arteriosus (PDA) treatment rates (pharmacologic or surgical) and neonatal outcomes. This cohort study included infants born at 24-28 weeks of gestation and birth weight <1500 g in 2007-2015 in NICUs caring for ≥100 eligible infants in 6 countries. The ratio of observed/expected (O/E) PDA treatment rates was derived for each NICU by estimating the expected rate using a logistic regression model adjusted for potential confounders and network. The primary composite outcome was death or severe neurologic injury (grades III-IV intraventricular hemorrhage or periventricular leukomalacia). The associations between the NICU-level O/E PDA treatment ratio and neonatal outcomes were assessed using linear regression analyses including a quadratic effect (a square term) of the O/E PDA treatment ratio. From 139 NICUs, 39 096 infants were included. The overall PDA treatment rate was 45% in the cohort (13%-77% by NICU) and the O/E PDA treatment ratio ranged from 0.30 to 2.14. The relationship between the O/E PDA treatment ratio and primary composite outcome was U-shaped, with the nadir at a ratio of 1.13 and a significant quadratic effect (P<.001). U-shaped ...Continue Reading

Citations

Feb 19, 2021·The Journal of Pediatrics·Sarah E SeatonUNKNOWN SwissNeoNet (Swiss Neonatal Network)
Mar 12, 2021·Seminars in Fetal & Neonatal Medicine·Kenichi Masumoto, Satoshi Kusuda
May 2, 2021·Pediatrics and Neonatology·Hsiao-Wen HuangReyin Lien
Jun 23, 2021·The Journal of Pediatrics·Mark AdamsUNKNOWN Swiss Neonatal Network & Follow-Up Group

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