Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 May 21;11(1):10689.
doi: 10.1038/s41598-021-89868-z.

Patent ductus arteriosus treatment trends and associated morbidities in neonates

Affiliations

Patent ductus arteriosus treatment trends and associated morbidities in neonates

Joonsik Park et al. Sci Rep. .

Abstract

To evaluate national epidemiologic data on infants treated for patent ductus arteriosus (PDA) in Korea and analyze outcomes associated with different PDA treatments. We retrospectively evaluated data on 12,336 patients diagnosed with PDA (International Classification of Diseases-10 code: Q250) between 2015 and 2018 from the Health Insurance Review and Assessment database. Among them, 1623 patients underwent surgical ligation (code: O1671). We used birth certificate data from Statistics Korea to estimate the prevalence, diagnosis, and treatment of PDA. The prevalence of infants with PDA was 81 infants per 10,000 live births and 45.2% in very low birth weight (VLBW) infants, which increased from 2015 to 2018. PDA ligation was performed in 2571 infants and 22% VLBW infants. Medical treatment was administered to 4202 infants, which decreased significantly, especially in VLBW infants (62% to 53%). The proportion of treatment was as follows: conservative treatment (53.1%), intravenous ibuprofen (24.4%), surgery (20.4%), and oral ibuprofen (10.7%); that among 4854 VLBW infants was as follows: intravenous ibuprofen (46.3%), conservative treatment (33.2%), surgery (22.2%), and oral ibuprofen (14.2%). Surgical treatment had a significantly higher risk (odds ratio 1.36) of mortality than conservative treatment. Surgical and/or medical treatments were associated with a higher risk of morbidity. Recently, increased use of conservative management of PDA has contributed to improved neonatal outcomes in VLBW infants. Select patients may still benefit from surgical ligation following careful consideration.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Distribution of PDA treatment strategy among the (A) neonate and (B) VLBW infants in Korea.
Figure 2
Figure 2
PDA treatment strategy by year among the (A) neonate and (B) VLBW infants in Korea.
Figure 3
Figure 3
The prevalence of morbidities and mortality according to the treatment strategy by year in VLBW infants.

References

    1. Sellmer A, Bjerre JV, Schmidt MR, McNamara PJ, Hjortdal VE, Høst B, et al. Morbidity and mortality in preterm neonates with patent ductus arteriosus on day 3. Arch. Dis. Child. Fetal Neonatal. Ed. 2013;98:F505–F510. doi: 10.1136/archdischild-2013-303816. - DOI - PubMed
    1. Hamrick SE, Hansmann G. Patent ductus arteriosus of the preterm infant. Pediatrics. 2010;125:1020–1030. doi: 10.1542/peds.2009-3506. - DOI - PubMed
    1. Malviya MN, Ohlsson A, Shah SS. Surgical versus medical treatment with cyclooxygenase inhibitors for symptomatic patent ductus arteriosus in preterm infants. Cochrane Database Syst Rev. Cd003951 (2013) - PMC - PubMed
    1. Mirea L, Sankaran K, Seshia M, Ohlsson A, Allen AC, Aziz K, et al. Treatment of patent ductus arteriosus and neonatal mortality/morbidities: adjustment for treatment selection bias. J. Pediatr. 2012;161:689–694. doi: 10.1016/j.jpeds.2012.05.007. - DOI - PubMed
    1. Clyman R, Cassady G, Kirklin JK, Collins M, Philips JB., III The role of patent ductus arteriosus ligation in bronchopulmonary dysplasia: reexamining a randomized controlled trial. J. Pediatr. 2009;154:873–876. doi: 10.1016/j.jpeds.2009.01.005. - DOI - PMC - PubMed

MeSH terms

LinkOut - more resources