Related Factors of Patent Ductus Arteriosus in Preterm Infants: A Systematic Review and Meta-Analysis
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Published on: January 27, 2023
Chang Liu1,2,3, Xingwang Zhu1,2,3, Dinggang Li1,2,3
1Department of Neonatology, Children's Hospital of Chongqing Medical University, Chongqing, China.
Insights
Patent ductus arteriosus (PDA) is common in preterm infants. Factors like lower gestational age and birth weight increase PDA risk, while being small for gestational age may decrease it.
Area of Science:
- Neonatal Medicine
- Pediatric Cardiology
- Perinatology
Background:
- Patent ductus arteriosus (PDA) poses significant risks during the neonatal period, particularly for preterm infants.
- Identifying factors associated with PDA is crucial for improving infant outcomes.
Approach:
- A comprehensive literature review was performed across PubMed, EMBASE, and Web of Science.
- Pooled odds ratios and standard mean differences were calculated to analyze dichotomous and continuous variables.
- Heterogeneity, publication bias, and sensitivity analyses were conducted for identified factors.
Key Points:
- Chorioamnionitis, lower gestational age, lower birth weight, bronchopulmonary dysplasia, intraventricular hemorrhage, necrotizing enterocolitis, respiratory distress syndrome, sepsis, surfactant treatment, ventilation, and lower platelet count were positively correlated with PDA.
- Being small for gestational age was associated with a decreased incidence of PDA.
- Premature rupture of membranes, preeclampsia, antenatal steroids, male gender, mean platelet volume, and platelet distribution width showed no significant relationship with PDA.
Conclusions:
- Preterm infants with more immature characteristics exhibit a higher likelihood of developing PDA.
- These findings can inform the prevention, diagnosis, and management strategies for PDA in preterm infants.
Abstract:
Background: Patent ductus arteriosus (PDA) is a dramatically harmful disease in the neonatal period, in particular common in preterm infants, and our study was to determine related factors of PDA in preterm infants. Methods: A comprehensive literature review was conducted in PubMed, EMBASE, and Web of Science. The pooled odds ratio and standard mean difference were calculated to compare dichotomous and continuous variables, respectively. In addition, we also assessed the heterogeneity and publication bias and carried out sensitivity analysis for each related factor. Results: We included 45 studies with 87,419 individuals. After the primary analysis and a series of adjustments, results showed chorioamnionitis, lower gestational age, lower birth weight, bronchopulmonary dysplasia, intraventricular hemorrhage, necrotizing enterocolitis, respiratory distress syndrome, sepsis, surfactant treatment, ventilation, and lower platelet count had a positive correlation with PDA, while small for gestational age decreased the incidence of PDA in preterm infants. Besides, premature rupture of membranes, preeclampsia, antenatal steroids, male gender, mean platelet volume, and platelet distribution width were found to have no statistically significant relationship with PDA. Conclusion: Preterm infants with more immature characteristics generally have a higher likelihood to develop PDA. The prevention, diagnosis, and management of PDA may depend on these results, and effective measures can be taken accordingly.
