Related Experiment Video
Updated: May 9, 2026
Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
Published on: January 27, 2023
The association between patent ductus arteriosus and adverse outcomes in preterm infants
Yaqi Tang1, Xiuxiang Liu2, Dongxu Wei2
1Heart Center, Women and Children's Hospital, Qingdao University, 6 Tongfu Road, Shibei District, Qingdao, Shandong, 266034, China.
Insights
Patent ductus arteriosus (PDA) treatment in preterm infants reduced necrotizing enterocolitis (NEC) risk but increased bronchopulmonary dysplasia (BPD) risk. Cesarean delivery also lowered BPD risk.
Area of Science:
- Neonatal Medicine
- Pediatric Cardiology
- Perinatology
Background:
- Patent ductus arteriosus (PDA) is common in preterm infants, with its association with necrotizing enterocolitis (NEC) and bronchopulmonary dysplasia (BPD) debated.
- Management strategies for PDA, including pharmacotherapy, aim to improve neonatal outcomes.
Purpose of the Study:
- To investigate the impact of PDA and its management on NEC and BPD risk in preterm infants.
- To identify independent risk factors for PDA, NEC, and BPD.
Main Methods:
- A single-center study of 769 preterm infants (<37 weeks gestational age).
- Logistic regression analysis to identify risk factors for PDA, NEC, and BPD.
- Evaluation of pharmacotherapy effects on neonatal outcomes.
Main Results:
- PDA was not associated with NEC risk (P=0.15).
- Infants with PDA had a 2.12-fold higher likelihood of BPD (P<0.01).
- PDA pharmacotherapy correlated with 49% lower NEC and 59% higher BPD incidence (P<0.01).
- Assisted reproductive technology (ART) and maternal diabetes were linked to PDA.
- Cesarean delivery was associated with 42% lower BPD risk (P<0.01).
Conclusions:
- PDA pharmacotherapy independently reduced NEC risk but increased BPD risk.
- ART is an independent risk factor for PDA and a confounder for NEC.
- Cesarean delivery is independently associated with reduced BPD risk.
Objective:
The impact of patent ductus arteriosus (PDA) and its management on necrotizing enterocolitis (NEC) and bronchopulmonary dysplasia (BPD) risk in preterm infants remains debated.
Methods:
The present single-center study enrolled a total of 769 preterm infants with a gestational age of less than 37 weeks. The logistic regression was used to identify independent risk factors for PDA, NEC, and BPD based on maternal conditions during pregnancy, delivery details, and postnatal neonatal characteristics. Furthermore, the present study evaluated the effects of drug treatment for PDA on neonatal outcomes.
Results:
The incidence of NEC was not associated with the presence of PDA in preterm infants (P = 0.15). However, infants with PDA had a 2.12-fold higher likelihood of developing BPD compared to those without PDA (P < 0.01). Pharmacotherapy for PDA was associated with a 49% lower incidence of NEC and a 59% higher incidence of BPD (P < 0.01). Assisted reproductive technology and maternal diabetes were identified as factors independently associated with PDA in preterm infants. Additionally, infants delivered by cesarean section had a 42% lower incidence of BPD compared to those delivered vaginally (P < 0.01).
Conclusion:
Pharmacotherapy for PDA was independently associated with a lower risk of NEC but a higher risk of BPD in preterm infants. ART was an independent risk factor for PDA and served as a confounding factor for NEC. Cesarean delivery was independently associated with a lower risk of BPD.
