Evaluation of the association between patent ductus arteriosus approach and neurodevelopment in extremely preterm infants

Objective Assess if unit-level PDA management correlates with neurodevelopmental impairment (NDI) at 18–24 months corrected postnatal age (CPA) in extremely preterm infants. Study design Retrospective analysis of infants born at <29 weeks (2014–2017) across two units having distinct PDA strategies. Site 1 utilized an echocardiography-based treatment strategy aiming for accelerated closure (control). Site 2 followed a conservative approach. Primary endpoint: NDI, characterized by cerebral palsy, any Bayley-III composite score <85, sensorineural/mixed hearing loss, or at least unilateral visual impairment. Results 377 infants were evaluated. PDA treatment rates remained unchanged in Site 1 but eventually reached 0% in Site 2. Comparable rates of any/significant NDI were seen across both sites (any NDI: 38% vs 36%; significant NDI: 13% vs 10% for Site 1 and 2, respectively). After adjustments, NDI rates remained similar. Conclusion PDA management strategies in extremely preterm newborns showed no significant impact on neurodevelopment outcomes at 18–24 months CPA.