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Background: The Victorian Infant Collaborative Study Group has reported that surgery with general anesthesia during the initial hospitalization increases the risk of adverse sensorineural outcome in ELBW infants. PDA ligation was the single most frequent type of surgery in this study.

Objective: To determine whether surgical PDA closure was a risk factor for neurosensory impairment in ELBW infants who participated in the international Trial of Indomethacin Prophylaxis in Preterms (TIPP).

Methods: Using the TIPP database, we studied 1180 children who survived their first day of birth. Infants were divided into 3 groups according to their PDA status in the NICU:‘No PDA',‘Non-surgical PDA', and ‘Surgical PDA'. As in TIPP, the primary outcome was a composite of death or neurosensory impairment at a corrected age of 18 months (cerebral palsy, cognitive delay, deafness, and blindness). Deaths and impairments were …