Related Experiment Videos
Patent ductus arteriosus in a cohort of 1338 preterm infants: a collaborative study
M van de Bor1, S P Verloove-Vanhorick, R Brand
1Department of Paediatrics, University Hospital, Leiden, The Netherlands.
Insights
Symptomatic patent ductus arteriosus (PDA) affects 10.7% of very preterm infants. Idiopathic respiratory distress syndrome (IRDS), sepsis, and low birthweight are key risk factors for PDA development.
Area of Science:
- Neonatalogy
- Perinatal Medicine
- Pediatric Cardiology
Background:
- Patent ductus arteriosus (PDA) is a common complication in preterm infants.
- Understanding PDA incidence and risk factors is crucial for improving neonatal outcomes.
Purpose of the Study:
- To determine the incidence of symptomatic PDA in infants born at less than 32 weeks gestation or weighing less than 1500 g.
- To identify maternal and perinatal factors predicting PDA development.
- To investigate PDA as a predictor for bronchopulmonary dysplasia (BPD) and necrotising enterocolitis (NEC).
Main Methods:
- Prospective national survey of infants born <32 weeks or <1500 g in the Netherlands.
- Established PDA presence/absence in infants surviving at least 24 hours.
- Logistic regression analysis to identify predictive factors for PDA.
Main Results:
- The incidence of symptomatic PDA was 10.7% in the studied cohort.
- Idiopathic respiratory distress syndrome (IRDS), septicaemia, birthweight, prolonged rupture of membranes, and gestational age were significant predictors of PDA.
- PDA was associated with increased risk of BPD and NEC.
Conclusions:
- IRDS, very preterm birth, and septicaemia are high-risk indicators for PDA.
- Early identification and management of PDA are essential in high-risk neonates.
- PDA is a significant risk factor for severe neonatal morbidities like BPD and NEC.
Abstract:
As part of a prospective national survey on morbidity and mortality of all infants born at less than 32 weeks and/or weighing less than 1500 g in the Netherlands we studied the incidence of symptomatic patent ductus arteriosus (PDA) in infants surviving at least 24 hours. In 1252 of the 1338 infants the presence or absence of PDA could be established. The incidence of PDA was 10.7%. Logistic regression analyses revealed that idiopathic respiratory distress syndrome (IRDS) was the most predictive factor, followed in order of importance by septicaemia, birthweight, prolonged rupture of membranes and gestational age. None of the other maternal and perinatal factors showed any association with the occurrence of PDA. Furthermore, bronchopulmonary dysplasia (BPD) and necrotising enterocolitis (NEC) were found to be sequelae of PDA. The combination of IRDS, very pre-term birth and septicaemia should be considered as high risk for the development of PDA.