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Does Postmenstrual Age Affect Medical Patent Ductus Arteriosus Treatment Success in Preterm Infants?

Sharandeep Kaur1, Amelie Stritzke2,3, Amuchou Singh Soraisham2,3

  • 1Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.

American Journal of Perinatology
|February 7, 2019
PubMed

Insights

Gestational age (GA), not postmenstrual age (PMA), is the key factor influencing treatment success for premature infants with patent ductus arteriosus (PDA). This finding impacts how medical interventions for PDA are approached in neonates.

Area of Science:

  • Neonatal Medicine
  • Pediatric Cardiology
  • Pharmacology

Background:

  • Patent ductus arteriosus (PDA) is a common cardiovascular complication in premature infants.
  • Effective medical management of PDA is crucial for improving outcomes in neonates.

Purpose of the Study:

  • To investigate the impact of postmenstrual age (PMA) on the response to medical treatment for PDA.
  • To identify predictors of successful medical PDA treatment in preterm infants.

Main Methods:

  • Retrospective cohort study of infants with gestational age (GA) ≤ 32 weeks treated with nonsteroidal anti-inflammatory drugs (NSAIDs) for PDA.
  • Analysis of response rates to NSAID treatment across one to three courses.
  • Multivariable logistic regression using generalized estimating equations to assess the association between PMA, GA, and treatment response.

Main Results:

  • A total of 183 infants received 257 courses of NSAIDs for PDA.
  • The initial response rate to NSAIDs was 65.6%, with lower rates for subsequent courses.
  • Postmenstrual age (PMA) was not significantly associated with a positive response to medical PDA treatment (aOR: 0.88; 95% CI: 0.71-1.10).
  • Gestational age (GA) at birth was the most significant predictor of a positive response (aOR: 1.33; 95% CI: 1.02-1.73).

Conclusions:

  • Gestational age at birth, rather than postmenstrual age, is the strongest predictor of successful medical treatment for patent ductus arteriosus.
  • Clinical management strategies for PDA in preterm infants should prioritize factors related to initial gestational age.
Abstract

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