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Patent ductus arteriosus in preterm newborns: A tertiary hospital experience
Joana Santos1, Paulo Soares2, Cristina Ferreras3
1Faculty of Medicine of the Universidade do Porto, Portugal.
Insights
This study identified factors predicting medical treatment success for patent ductus arteriosus (PDA) in preterm infants. A predictive model was developed to optimize PDA management and improve outcomes for non-responders.
Area of Science:
- Neonatal Medicine
- Pediatric Cardiology
- Clinical Research
Background:
- Patent ductus arteriosus (PDA) is a common complication in preterm infants, linked to higher mortality and morbidity.
- Effective management of PDA is crucial for improving outcomes in vulnerable preterm populations.
Purpose of the Study:
- To characterize preterm infants with PDA.
- To identify predictors of successful medical treatment for PDA using ibuprofen.
- To develop a model for predicting treatment response.
Main Methods:
- Retrospective observational study of 81 preterm infants (23-32 weeks GA) with PDA.
- Univariate comparative analysis of factors influencing ibuprofen treatment efficacy.
- Multivariate logistic regression to build a predictive model for PDA closure.
Main Results:
- Gestational age, delivery type, diuretic use, and platelet transfusion were significant factors in univariate analysis.
- A predictive model demonstrated 72.2% discriminative capacity, 98.1% sensitivity, and 57.1% specificity.
- Ibuprofen efficacy varied significantly based on several clinical variables.
Conclusions:
- A predictive model for PDA treatment efficacy in preterm infants was successfully developed.
- This model can aid in optimizing medical strategies for PDA, particularly for non-responders.
- Characterization of the PDA population provides valuable insights for clinical practice.
Introduction:
Patent ductus arteriosus (PDA) in preterm infants has been associated with increased mortality and comorbidities. This study aimed to characterize the population of preterm infants diagnosed with PDA and to identify predictive factors of response to medical treatment of PDA.
Methods:
An eight-year retrospective observational study was carried out, which included all preterm infants with a gestational age (GA) between 23 and 32 weeks diagnosed with PDA, admitted to the Neonatal Unit of the CHUSJ. Univariate comparative analysis was performed, and models for predicting the effectiveness of PDA treatment with ibuprofen were explored by multivariate logistic regression analysis.
Results:
115 cases were included and 34 were excluded, with a final sample of 81 preterm infants with PDA. The univariate analysis revealed significant differences in the closure efficacy via medical treatment with ibuprofen in several variables, and a multivariate logistic regression model was obtained (discriminative capacity 72.2%, sensitivity 98.1%, specificity 57.1%), taking into account the effect of GA, type of delivery, need for diuretics treatment and platelet transfusion.
Conclusion:
This study enabled the population of preterm infants diagnosed with PDA to be characterized and the identification of a predictive model that can help predict the efficacy of medical treatment and thus contribute to optimizing the medical approach to the non-responders.
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