Can Treatment of Patent Ductus Arteriosus with Ibuprofen Compared to Supportive Management Affect Regional Brain Volume in Very Low Birth Weight Infants? A Pilot Study

Purpose: This study aimed to compare cerebral hemispheric volumes between pharmacologic treatment and supportive management of patent ductus arteriosus (PDA). Methods: The study was conducted retrospectively. The subjects of period 1 group were very low birth weight infants whose PDA were treated with pharmacologic closure. Period 2 group were treated with supportive management. Regional brain volumes measured using magnetic resonance imaging were compared between the two groups. Results: A total of 12 infants were included. Their median gestational age was 27+6 (range: 24+1–31+1) weeks and birth weight was 1,065 g (range: 690–1,380). Between the two groups, there was no difference in Apgar score, incidence of bronchopulmonary dysplasia, necrotizing enterocolitis, and culture proven sepsis. The regional brain volumes such as gray matter (Period 1 group, 76,833 mm3 [55,759–100,388] vs. Period 2 group, 79,870 mm3 [59,957–113,018], P=0.59), white matter (82,993 mm3 [63,130–121,311] vs. 92,576 mm3 [77,200–104,506], P=0.18), cerebrospinal fluid (17,167 mm3 [9,279–22,760] vs. 14,348 mm3 [7,018–27,604], P=0.94), basal ganglia (2,065 mm3 [1,697 –2,482] vs. 2,306 mm3 [2,065–3,009], P=0.18), and cerebellum (18,374 mm3 [14,843–24,657] vs. 18,096 mm3 [16,134–23,627], P=0.94) were not different between the two groups. Conclusion: Regional brain volumes were not different between pharmacological and conservative treatment in infants with PDA. Further wellcontrolled studies are required to evaluate the advantages or disadvantages of supportive management without pharmacologic treatment of PDA.