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首页> 外文期刊>BMC Pediatrics >A prospective study of maternal preference for indomethacin prophylaxis versus symptomatic treatment of a patent ductus arteriosus in preterm infants
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A prospective study of maternal preference for indomethacin prophylaxis versus symptomatic treatment of a patent ductus arteriosus in preterm infants

机译：孕妇对吲哚美辛的预防与对症治疗动脉导管未闭的对症治疗的前瞻性研究

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Background The management of a patent ductus arteriosus in preterm infants continues to be debated among neonatologists due to the absence of concrete evidence that precisely weighs the long term outcomes of active, early intervention against a conservative approach. In the majority of institutions, parents are encouraged to play an active role in the complex, decision –making processes with regard to the care of their infants. The objective of this study is to elicit maternal preferences for indomethacin prophylaxis versus treatment of a patent ductus arteriosus (PDA) in extremely low birth weight (ELBW) infants, utilizing a decision aid instrument (DAI). Methods Healthy and high risk pregnant women at 23–28 weeks gestation, and mothers of admitted ELBW infants were enrolled. A computer based, validated DAI was utilized during interviews. The DAI first provides information about prematurity and concurrent morbidities with comprehensive facts of the pros and cons about prophylactic versus treatment options. It subsequently coaches participants how to select values and preferences based on their decisions. A 17-item questionnaire assessed and valued each short and long term morbidity of extreme prematurity and preferred choice for PDA management. Results Two hundred ninety nine subjects were enrolled; 75% were healthy women at 23–28 weeks gestation, 19% were high risk and 6% recently delivered an ELBW infant. Eighty-two percent preferred a prophylactic indomethacin strategy versus symptomatic treatment for the management of PDA. Across a spectrum of potential morbidities, the occurrence of severe intraventricular hemorrhage was viewed by mothers as the most un-wanted outcome irrespective of the two proposed options. Conclusions In contrast to neonatal practitioners, mothers who used this particular DAI strongly endorsed prophylactic indomethacin versus a treatment intervention for the management of PDA in preterm infants.
机译：背景技术由于缺乏具体的证据准确地权衡积极，早期干预与保守治疗的长期结果之间的关系，新生儿科医师在早产儿动脉导管未闭的治疗方面仍存在争议。在大多数机构中，都鼓励父母在照顾婴儿的复杂决策过程中发挥积极作用。这项研究的目的是利用决策辅助工具（DAI）来激发孕妇对消炎痛的预防，而不是对极低出生体重（ELBW）婴儿的动脉导管未闭（PDA）的治疗。方法纳入妊娠23-28周的健康和高风险孕妇，以及入院的ELBW婴儿的母亲。采访期间使用了基于计算机的，经过验证的DAI。 DAI首先提供有关早产和并发疾病的信息，以及有关预防和治疗选择的优缺点的综合事实。随后，它指导参与者如何根据他们的决定选择价值和偏好。一份17项问卷调查表评估并评估了极端早产的每种短期和长期发病率以及PDA管理的首选选择。结果共招募299名受试者。妊娠23–28周时，健康的女性占75％，高风险的女性占19％，最近分娩的ELBW婴儿为6％。有百分之八十二的患者首选对消炎痛策略，而不是对症治疗，以控制PDA。在各种潜在的发病率中，无论是否有两个建议的方案，母亲都认为严重的脑室内出血是最不需要的结局。结论与新生儿从业者相反，使用这种特殊DAI的母亲强烈赞成预防性消炎痛与早产儿PDA治疗的干预措施。

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