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A Mystery of Patent Ductus Arteriosus and Serum Osmolality in Preterm Infants

Ufuk Cakir1, Cuneyt Tayman1

  • 1Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey.

American Journal of Perinatology
|October 7, 2018
PubMed

Insights

Elevated serum osmolality in preterm infants may indicate a patent ductus arteriosus (PDA). Higher osmolality levels were observed in infants with hemodynamically significant PDA (hsPDA), suggesting its role in ductal patency.

Area of Science:

  • Neonatal Medicine
  • Pediatric Cardiology
  • Clinical Physiology

Background:

  • Patent ductus arteriosus (PDA) is a significant clinical issue in preterm infants, linked to increased mortality and morbidity.
  • The relationship between serum osmolality and ductal patency is not fully understood but is hypothesized to play a role.

Purpose of the Study:

  • To investigate the association between serum osmolality and the presence of hemodynamically significant PDA (hsPDA) in preterm infants.
  • To determine if serum osmolality can serve as a predictor for hsPDA in this vulnerable population.

Main Methods:

  • A retrospective study involving 799 preterm infants (birth weight <1,500g, gestational age <32 weeks) between January 2013 and December 2017.
  • Comparison of mean serum osmolality levels between infants diagnosed with hsPDA and those without hsPDA.
  • Analysis of receiver operating characteristic (ROC) curve to evaluate the predictive value of serum osmolality for hsPDA.

Main Results:

  • Mean serum osmolality was significantly higher in infants with hsPDA (297 ± 10.9 mOsm/L) compared to those without hsPDA (292 ± 8.3 mOsm/L) (p=0.001).
  • The area under the ROC curve for serum osmolality in predicting hsPDA was 0.582 (p=0.0006).
  • A serum osmolality cutoff value of 300 mOsm/L was identified as a potential predictor for hsPDA.

Conclusions:

  • Serum osmolality may be an important factor contributing to ductal patency in preterm infants.
  • This finding is particularly relevant for extremely preterm infants at higher risk for hsPDA in the early neonatal period.
Abstract

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