Factors Associated With Benefit of Treatment of Patent Ductus Arteriosus in Preterm Infants: A Systematic Review and Meta-Analysis

• Published in: Frontiers in pediatrics 2021-02, Vol.9, p.626262-626262
• Main Authors: Jansen, Esther J S, Hundscheid, Tim, Onland, Wes, Kooi, Elisabeth M W, Andriessen, Peter, de Boode, Willem P
• Format: Article
• Language: English
• Subjects: acetaminophen; ductus botalli; ibuprofen; indometacin; patent ductus arteriosis; Pediatrics; premature (babies)
• ISSN: 2296-2360; 2296-2360
• DOI: 10.3389/fped.2021.626262

There is an ongoing debate on the optimal management of patent ductus arteriosus (PDA) in preterm infants. Identifying subgroup of infants who would benefit from pharmacological treatment might help. To investigate the modulating effect of the differences in methodological quality, the rate of open-label treatment, and patient characteristics on relevant outcome measures in randomized controlled trials (RCTs). Electronic database search between 1950 and May 2020. RCTs that assessed pharmacological treatment compared to placebo/no treatment. Data is extracted following the PRISMA guidelines. Outcome measures were failure to ductal closure, surgical ligation, incidence of necrotizing enterocolitis, bronchopulmonary dysplasia, sepsis, periventricular leukomalacia, intraventricular hemorrhage (IVH) grade ≥3, retinopathy of prematurity and mortality. Forty-seven studies were eligible. The incidence of IVH grade ≥3 was lower in the treated infants compared to the placebo/no treatment (RR 0.77, 95% CI 0.64-0.94) and in the subgroups of infants with either a gestational age