期刊
AMERICAN JOURNAL OF PERINATOLOGY
卷 37, 期 2, 页码 216-223出版社
THIEME MEDICAL PUBL INC
DOI: 10.1055/s-0039-1697672
关键词
ductus arteriosus; bronchopulmonary dysplasia; death; extremely low gestational age infants
资金
- U.S. Public Health Service National Heart, Lung and Blood Institute [HL109199]
Objective This study was aimed to examine the relationship between duration of infant exposure to a moderate-to-large patent ductus arteriosus (PDA) shunt and the risk of developing bronchopulmonary dysplasia (BPD) or death before 36 weeks (BPD/death). Study Design Infants <28 weeks' gestation who survived >= 7 days ( n = 423) had echocardiograms performed on day 7 and at planned intervals. Results In multivariable regression models, BPD/death did not appear to be increased until infants had been exposed to a moderate-to-large PDA for at least 7-13 days: OR (95%CI) (referent = closed or small PDA): moderate-to-large PDA exposure for <7 days: 0.38 (range, 0.10-1.46); for 7 to 13 days = 2.12 (range, 1.04-4.32); for >= 14 days = 3.86 (range, 2.15-6.96). Once the threshold of 7 to 13 days had been reached, additional exposure (>= 14 days) did not significantly add to the increased incidence of BPD/death: (referent exposure = 7-13 days) exposure for 14 to 27 days = 1.34 (range, 0.52-3.45); for 28 to 48 days = 2.34 (range, 0.88-6.19); for >= 49 days = 1.80 (range. 0.59-5.47). A similar relationship was found for the outcome of BPD-alone. Conclusion Infants < 28 weeks' gestation required at least 7 to 13 days of exposure to a moderate-to-large PDA before a significant increase in the incidence of BPD/death was apparent. Once this threshold was reached additional exposure to a moderate-to-large PDA did not significantly add to the increased incidence of BPD/death.
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