{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:11:31Z","timestamp":1753891891724,"version":"3.41.2"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,3,18]],"date-time":"2021-03-18T00:00:00Z","timestamp":1616025600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:p><jats:bold>Introduction:<\/jats:bold> There are still uncertainties about the timing and indication for surgical ligation of patent ductus arteriosus (PDA) in pre-term infants, where lower gestational age (GA) usually is predictive for surgical treatment.<\/jats:p><jats:p><jats:bold>Objective:<\/jats:bold> Our aim was to assess differences in clinical characteristics and outcomes between surgically treated and matched non-surgically treated PDA in extremely pre-term infants.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> All extremely pre-term infants born 2010\u20132016 with surgically treated PDA (Ligated group; <jats:italic>n<\/jats:italic> = 44) were compared to non-surgically treated infants (Control group; <jats:italic>n<\/jats:italic> = 44) matched for gestational age (+\/\u22121 week) and time of birth (+\/\u22121 month). Perinatal parameters, echocardiographic variables, details of pharmacological PDA treatment, morbidity, and mortality were assessed.<\/jats:p><jats:p><jats:bold>Result:<\/jats:bold> Mean GA and birthweight were similar between the Ligated group (24<jats:sup>+5<\/jats:sup> \u00b1 1<jats:sup>+3<\/jats:sup> weeks and 668 \u00b1 170 g) and the Control group (24<jats:sup>+5<\/jats:sup> \u00b1 1<jats:sup>+3<\/jats:sup> weeks and 704 \u00b1 166 g; <jats:italic>p<\/jats:italic> = 1.000 and <jats:italic>p<\/jats:italic> = 0.319, respectively). Infants in the Ligated group had larger ductal diameters prior to pharmacological treatment, and lack of diameter decrease and PDA closure after treatment (<jats:italic>p<\/jats:italic> = 0.022, <jats:italic>p<\/jats:italic> = 0.043 and 0.006, respectively). Transfusions, post-natal steroids and invasive respiratory support were more common in the Ligated group. Except for a higher incidence of severe bronchopulmonary dysplasia (BPD) in the Ligated group there were no other differences in outcomes or mortality between the groups.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> Early large ductal diameter and reduced responsiveness to pharmacological treatment predicted the need for future surgical ligation in this matched cohort study of extremely pre-term infants where the effect of GA and differences in treatment strategies were excluded. Besides an increased incidence of severe BPD in the Ligated group, no other differences in morbidity or mortality were detected.<\/jats:p>","DOI":"10.3389\/fped.2021.648372","type":"journal-article","created":{"date-parts":[[2021,3,18]],"date-time":"2021-03-18T08:16:26Z","timestamp":1616055386000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["A Matched Case Control Study of Surgically and Non-surgically Treated Patent Ductus Arteriosus in Extremely Pre-term Infants"],"prefix":"10.3389","volume":"9","author":[{"given":"Karl Wilhelm","family":"Olsson","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sawin","family":"Youssef","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mattias","family":"Kjellberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renske","family":"Raaijmakers","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Sindelar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,3,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1016\/j.siny.2018.03.004","article-title":"Continued uncertainty regarding treatment of patent ductus arteriosus in premature infants and the role of clinical trials","volume":"23","author":"Juszczak","year":"2018","journal-title":"Semin Fetal Neonatal Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1016\/j.jpeds.2017.06.054","article-title":"Treatment and nontreatment of the patent ductus arteriosus: identifying their roles in neonatal morbidity","volume":"189","author":"Clyman","year":"2017","journal-title":"J Pediatr."},{"key":"B3","doi-asserted-by":"publisher","first-page":"F474","DOI":"10.1136\/archdischild-2014-306214","article-title":"Reflections of the changes in patent ductus arteriosus management during the last 10 years","volume":"101","author":"El-Khuffash","year":"2016","journal-title":"Arch Dis Child Fetal Neonatal Ed."},{"key":"B4","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1016\/j.jpeds.2010.02.062","article-title":"Early surgical ligation versus a conservative approach for management of patent ductus arteriosus that fails to close after indomethacin treatment","volume":"157","author":"Jhaveri","year":"2010","journal-title":"J Pediatr."},{"key":"B5","doi-asserted-by":"publisher","first-page":"873","DOI":"10.1016\/j.jpeds.2009.01.005","article-title":"The role of patent ductus arteriosus ligation in bronchopulmonary dysplasia: reexamining a randomized controlled trial","volume":"154","author":"Clyman","year":"2009","journal-title":"J Pediatr."},{"key":"B6","doi-asserted-by":"publisher","first-page":"689","DOI":"10.1016\/j.jpeds.2012.05.007","article-title":"Treatment of patent ductus arteriosus and neonatal mortality\/morbidities: adjustment for treatment selection bias","volume":"161","author":"Mirea","year":"2012","journal-title":"J Pediatr."},{"key":"B7","doi-asserted-by":"publisher","first-page":"785","DOI":"10.1038\/pr.2016.166","article-title":"Trends and variation in management and outcomes of very low-birth-weight infants with patent ductus arteriosus","volume":"80","author":"Hagadorn","year":"2016","journal-title":"Pediatr Res."},{"key":"B8","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/j.jpeds.2018.09.012","article-title":"PDA-TOLERATE Trial. 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