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Pediatrics. 2016 Apr;137(4). pii: e20153090. doi: 10.1542/peds.2015-3090. Epub 2016 Mar 30.

Patent Ductus Arteriosus and Brain Volume.

Author information

1
Department of Neonatology, Wilhelmina Children's Hospital/University Medical Center Utrecht, Netherlands; p.lemmers@umcutrecht.nl.
2
Department of Neonatology, Wilhelmina Children's Hospital/University Medical Center Utrecht, Netherlands;
3
Department of Neonatology, Wilhelmina Children's Hospital/University Medical Center Utrecht, Netherlands; Division of Neonatology, Salesi's Children Hospital/UPM, Ancona, Italy; and.
4
Image Sciences Institute, University Medical Center Utrecht, Netherlands.

Abstract

BACKGROUND AND OBJECTIVES:

A hemodynamically significant patent ductus arteriosus (PDA) can compromise perfusion and oxygenation of the preterm brain. Reports suggest that PDA is associated with increased mortality and morbidity. We hypothesize that long-standing low cerebral oxygenation due to PDA might affect brain volume at term equivalent age.

METHODS:

Observational study in 140 infants investigating the relationship between near-infrared spectroscopy-monitored cerebral oxygen saturation (rSco2) and MRI-assessed regional brain volume and maturation of the posterior limb of the internal capsule at term-equivalent age in 3 groups: those whose PDA closed with indomethacin, those who needed additional surgical closure, and matched controls.

RESULTS:

The surgery group had the lowest rSco2 values before closure (n = 35), 48% ± 9.7% (mean ± SD) as compared with the indomethacin (n = 35), 59% ± 10.4 (P < .001), and control groups (n = 70), 66% ± 6.9 (P < .001); the highest postnatal age before effective treatment; and the lowest volumes of most brain regions at term-equivalent age. Multiple linear regression analysis showed a significant effect of preductal closure rSco2 on cerebellar volume in this group. No differences were found in maturation of the posterior limb of the internal capsule.

CONCLUSIONS:

Long-standing suboptimal cerebral oxygenation due to a PDA may negatively influence brain growth, affecting neurodevelopmental outcome.

PMID:
27030421
DOI:
10.1542/peds.2015-3090
[Indexed for MEDLINE]
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