Patent Ductus Arteriosus and Brain Volume

Pediatrics. 2016 Apr;137(4):e20153090. doi: 10.1542/peds.2015-3090. Epub 2016 Mar 30.


Background and objectives: A hemodynamically significant patent ductus arteriosus (PDA) can compromise perfusion and oxygenation of the preterm brain. Reports suggest that PDA is associated with increased mortality and morbidity. We hypothesize that long-standing low cerebral oxygenation due to PDA might affect brain volume at term equivalent age.

Methods: Observational study in 140 infants investigating the relationship between near-infrared spectroscopy-monitored cerebral oxygen saturation (rSco2) and MRI-assessed regional brain volume and maturation of the posterior limb of the internal capsule at term-equivalent age in 3 groups: those whose PDA closed with indomethacin, those who needed additional surgical closure, and matched controls.

Results: The surgery group had the lowest rSco2 values before closure (n = 35), 48% ± 9.7% (mean ± SD) as compared with the indomethacin (n = 35), 59% ± 10.4 (P < .001), and control groups (n = 70), 66% ± 6.9 (P < .001); the highest postnatal age before effective treatment; and the lowest volumes of most brain regions at term-equivalent age. Multiple linear regression analysis showed a significant effect of preductal closure rSco2 on cerebellar volume in this group. No differences were found in maturation of the posterior limb of the internal capsule.

Conclusions: Long-standing suboptimal cerebral oxygenation due to a PDA may negatively influence brain growth, affecting neurodevelopmental outcome.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brain / anatomy & histology*
  • Brain / blood supply
  • Brain / diagnostic imaging
  • Brain / metabolism
  • Ductus Arteriosus, Patent / pathology*
  • Ductus Arteriosus, Patent / surgery
  • Female
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases / diagnostic imaging
  • Infant, Premature, Diseases / metabolism
  • Infant, Premature, Diseases / pathology*
  • Linear Models
  • Magnetic Resonance Imaging
  • Male
  • Organ Size
  • Oxygen / blood


  • Oxygen