Related Experiment Video
Updated: Jan 19, 2026
Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
Published on: January 27, 2023
Hemodynamically significant PDA impacts adverse outcomes in infants with BPD: a multicenter study
Qianhan Ouyang1,2, Fei Bei3, Chongbing Yan1
1Department of Neonatology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Insights
In preterm infants with bronchopulmonary dysplasia (BPD), significant hemodynamic patent ductus arteriosus (hsPDA) is linked to pulmonary hypertension and extended need for invasive respiratory support, impacting infant outcomes.
Area of Science:
- Neonatalogy
- Pediatric Cardiology
- Respiratory Medicine
Background:
- Bronchopulmonary dysplasia (BPD) and significant hemodynamic patent ductus arteriosus (hsPDA) are prevalent complications in extremely preterm infants.
- The coexistence of BPD and hsPDA raises significant clinical concerns regarding infant prognosis.
Purpose of the Study:
- To investigate the association between hsPDA and adverse outcomes in infants diagnosed with BPD.
- To provide clinical evidence for improved management strategies in this vulnerable population.
Main Methods:
- Retrospective analysis of 781 preterm infants (<32 weeks) across three hospitals (2018-2023).
- Infants were categorized based on echocardiographic assessment into non-PDA, non-hsPDA, and hsPDA groups.
- Logistic and linear regression analyses were employed to assess the effects of hsPDA on short-term outcomes in BPD infants.
Main Results:
- In BPD infants, hsPDA was associated with increased risks of pneumonia, feeding intolerance, prolonged oxygen therapy, and pulmonary hypertension (PH).
- hsPDA independently correlated with a higher risk of neonatal PH (aOR = 7.502) and significantly longer invasive respiratory support duration (β = 6.530 days).
- Ductus arteriosus diameter >3 mm was linked to elevated risks of feeding intolerance, PH, and extrauterine growth restriction.
Conclusions:
- hsPDA is a significant independent risk factor for adverse outcomes in preterm infants with BPD.
- The findings underscore the importance of managing hsPDA to mitigate risks of PH and reduce the need for prolonged respiratory support in BPD infants.
Background:
Bronchopulmonary dysplasia (BPD) and significant hemodynamic patent ductus arteriosus (hsPDA) are both common and important clinical issues in extremely preterm infants. The potential impact on prognosis when these conditions coexist is a major focus of clinical concern. This study examined the relationship between hsPDA and adverse outcomes in BPD infants.
Methods:
A retrospective analysis of 781 preterm infants (<32 weeks) from three hospitals (2018-2023). Based on echocardiographic assessment, infants were categorized as the non-PDA group, the non-hsPDA group, or the hsPDA group. Further subgroups were formed according to treatment and ductus arteriosus size (<1.5 mm, 1.5-3 mm, ≥3 mm). The effects of hsPDA on short-term outcomes in infants with BPD were assessed using logistic regression and linear regression.
Results:
The study included 781 infants (548 non-BPD, 233 BPD). The hsPDA subgroup had lower gestational age, higher birth asphyxia rates, and required more invasive respiratory support. In BPD infants, hsPDA was linked to longer respiratory support, higher pneumonia and feeding intolerance risks, prolonged oxygen therapy, and PH. Infants with hsPDA had longer hospital stays and oxygen therapy. Intervention therapy in infants with hsPDA was associated with prolonged oxygen therapy duration, reduced feeding intolerance, and increased risk of pulmonary hypertension（PH）. Meanwhile, ductus arteriosus diameter >3 mm was linked to elevated risks of feeding intolerance, pulmonary hypertension, and extrauterine growth restriction. After adjusting for gestational age and birth weight, results from multivariate logistic regression and multiple linear regression analyses indicated that hsPDA was independently associated with increased risk of neonatal PH (aOR = 7.502, 95% CI: 4.046-13.911, P < 0.001) and significantly prolonged invasive respiratory support duration (β = 6.530 days, 95% CI: 1.691-11.368, P = 0.008).
Conclusion:
In BPD infants, hsPDA is associated with the occurrence of PH and longer duration of invasive respiratory support.
Impact:
This study highlights the significant correlation between hemodynamically significant patent ductus arteriosus (hsPDA) and adverse outcomes in infants diagnosed with bronchopulmonary dysplasia (BPD), providing valuable clinical evidence for better management strategies. This study adds to the literature by showing that in very preterm infants with BPD, the presence of hsPDA was independently correlated with both an increased risk of pulmonary hypertension and a longer duration of invasive respiratory support.
