No Lasting Benefit for Early Tx of Patent Ductus Arteriosus
(HealthDay News) — Early treatment to induce closure of the patent ductus arteriosus (PDA) in preterm infants does not improve long-term outcomes, according to a clinical report published online December 15 in Pediatrics.
Noting that in preterm infants, closure of the ductus arteriosus is delayed, William E. Benitz, MD, on behalf of the America Academy of Pediatrics Committee on Fetus and Newborn, summarizes the available evidence relating to evaluation and treatment of preterm infants with pronged ductal patency.
According to the report, although medical and surgical treatments are effective for closing the PDA, neither clinical trials nor meta-analyses have demonstrated improved long-term outcomes for closure of the ductus. Early routine treatment has no effect on the most important outcomes, including bronchopulmonary dysplasia, necrotizing enterocolitis, neurosensory impairment, and death. Insufficient data are available to examine the potential benefits of treatment initiated after 2 weeks of age. Furthermore, the evidence is insufficient to determine whether there are preterm infants who would benefit from early treatment. In addition, these data cannot be extrapolated to novel treatments.
"There is a lack of evidence to guide management of PDA, necessitating equipoise regarding treatment options and support for parents to permit enrollment of their infants in trials that can expand the available body of evidence," the authors write.