Patent ductus arteriosus and small for gestational age infants: Treatment approaches and outcomes

Aldana-Aguirre, Jose Carlos; Toye, Jennifer; Shah, Prakesh S.; Yoon, Eugene W.; Kumaran, Kumar

doi:10.1016/j.earlhumdev.2019.02.002

Cited by 6 publications

(5 citation statements)

References 25 publications

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“…It suggested that there was a risk of delay in the clinical diagnosis of PDA, which in turn increased the probability of neonatal lung disease and chronic bronchopneumonia and prolonged the use of ventilator. 5 - 7 Therefore, the diagnosis of PDA only based on neonatal ultrasound imaging findings may reduce the diagnostic sensitivity, which was similar to the findings of Lee. 8 Clinical symptoms can’t reflect the changes of neonatal cardiac load in time, and it is difficult to provide clinical basis for the early treatment of PDA.…”

Section: Discussionsupporting

confidence: 72%

Application of block matching method-based Echocardiography combined with serum NT-PROBNP level detection in the early prediction of PDA in premature infants

Wang¹,

Yun-long

Ji³

2021

Pak J Med Sci

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Objectives: The paper uses block matching method combined with echocardiography to explore the value of N-terminal pro-brain natriuretic peptide (NT-proBNP) in predicting symptomatic patent ductus arteriosus (PDA) in preterm infants. Methods: We selected premature infants born between February 2019 and March 2020, gestational age ≤32 weeks, and echocardiography within 48 hours to determine the presence of arterial ducts as the research object, monitor their clinical manifestations, and detect serum at three and five days after birth The level of NT-proBNP was checked with echocardiography, and the children were divided into PDA group and asymptomatic patent ductus arteriosus (aPDA) group according to the clinical manifestations and echocardiographic. Results: The area under the ROC curve of PDA predicted by serum NT-proBNP level at 3 days after birth was 0.949, the cut-off value was 27035pg/mL, the sensitivity was 92.3%, and the specificity was 94.6%; serum NT-proBNP level at 5 days after birth predicted the ROC curve of PDA The lower area is 0.924, the critical value is 6411 pg/mL, the sensitivity is 92.3%, and the specificity is 92.9%. Conclusion: NT-proBNP may be a quantitative indicator of arterial duct shunt; the detection of serum NT-proBNP levels at 3 and 5 days after birth is helpful for early prediction of PDA. doi: https://doi.org/10.12669/pjms.37.6-WIT.4864 How to cite this:Wang C, Shi Y, Ji J. Application of block matching method-based Echocardiography combined with serum NT-PROBNP level detection in the early prediction of PDA in premature infants. Pak J Med Sci. 2021;37(6):1657-1661. doi: https://doi.org/10.12669/pjms.37.6-WIT.4864 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionsupporting

confidence: 72%

Application of block matching method-based Echocardiography combined with serum NT-PROBNP level detection in the early prediction of PDA in premature infants

Wang¹,

Yun-long

Ji³

2021

Pak J Med Sci

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“…Severe outcomes, such as neonatal death, may have significantly weakened associations with SGA in high-resource settings with skilled birth attendants and neonatologists compared with low-resource settings, especially for minor or moderate SGA (ie, >3rd percentile and <10th percentile) 37. Some preterm-related complications, for example, necrotising enterocolitis, respiratory distress syndrome and intraventricular haemorrhage, are associated with SGA which was more commonly seen in moderate or late preterm neonates rather than very or extremely preterm neonates 5 10–12 16 38. Other conditions, including NICU admissions and low Apgar scores, were more sensitive to preterm birth rather than SGA, thus the larger the proportion of more immature babies classified as SGA, the greater the predictive power for the complications would be for the corresponding reference 37 39.…”

Section: Discussionmentioning

confidence: 99%

“…Birth weight is the most important anthropometric measure assessed in newborns. Abnormal birth weight is associated with neonatal mortality and morbidity and is also linked to long-term health 1–9. Birth weight charts are used for the classification of neonatal size and identification of high-risk infants, that is, those born small for gestational age (SGA, <10th percentile) or large for gestational age (LGA, >90th percentile).…”

Section: Introductionmentioning

confidence: 99%

“…Birth weight charts are used for the classification of neonatal size and identification of high-risk infants, that is, those born small for gestational age (SGA, <10th percentile) or large for gestational age (LGA, >90th percentile). SGA babies are at a higher risk of neonatal death, low Apgar scores, bronchopulmonary dysplasia, short-term complications (hypoglycaemia, hypothermia, polycythaemia, thrombocytopenia and neutropenia), and long-term complications (suboptimal growth, neurodevelopmental impairment, cardiovascular diseases and metabolic syndrome) 5–18. LGA babies have higher risks of suffering from birth injuries, birth asphyxia, persistent pulmonary hypertension of the newborn and childhood and adulthood overweight or obesity 1–4 19–21.…”

Section: Introductionmentioning

confidence: 99%

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Fitness of INTERGROWTH-21st birth weight standards for Chinese-ethnicity babies

Wang

Hui

Cole

et al. 2023

Arch Dis Child Fetal Neonatal Ed

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ObjectiveTo determine the fitness of the INTERGROWTH-21st birth weight standards (INTERGROWTH21) for ethnic Chinese babies compared with a local reference (FOK2003).DesignPopulation-based analysis of territory-wide birth data.SettingAll public hospitals in Hong Kong.ParticipantsLive births between 24 and 42 complete weeks’ gestation during 2006–2017.Main outcome measuresBabies’ birth weight Z-scores were calculated using published methods. The two references were compared in three aspects: (1) the proportions of large-for-gestational-age (LGA) or small-for-gestational-age (SGA) infants, (2) the gestation-specific and sex-specific mean birth weight Z-scores and (3) the predictive power for SGA-related complications.Results488 896 infants were included. Using INTERGROWTH21, among neonates born <33 weeks’ gestation, the mean birth weight Z-scores per week were closer to zero (−0.2 to 0.05), while most of them were further from zero (0.06 to 0.34) after excluding infants with a high risk of abnormal intrauterine growth. Compared with FOK2003, INTERGROWTH21 classified smaller proportions of infants as SGA (8.3% vs 9.6%) and LGA (6.6% vs 7.9%), especially SGA among preterm infants (13.1% vs 17.0%). The area under the receiver operating characteristic curve for predicting SGA-related complications was greater with FOK2003 (0.674, 95% CI 0.670 to 0.677) than INTERGROWTH21 (0.658, 95% CI 0.655 to 0.661) (p<0.001).ConclusionsINTERGROWTH21 performed less well than FOK2003, a local reference for ethnic Chinese babies, especially in infants born <33 weeks’ gestation. Although the differences are clinically small, both these references performed poorly for extremely preterm infants, and thus a more robust chart based on a larger sample of appropriately selected infants is needed.

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“…Premature infants are the key research focus of perinatal medicine. With the development of medical technology, the survival rate of premature infants has been significantly improved, followed by the prevention and treatment of complications (1). Patent ductus arteriosus (PDA) is a common complication in premature infants, which occurs mostly in very low birth weight infants (2).…”

Section: Introductionmentioning

confidence: 99%

Change and clinical significance of serum cortisol, BNP, and PGE-2 levels in premature infants with patent ductus arteriosus

Cui

Liu

et al. 2021

Transl Pediatr

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Background:To analyze the change and clinical significance of cortisol, B-type brain natriuretic peptide (BNP), and prostacyclin-2 (PGE-2) levels in premature infants with patent ductus arteriosus (PDA).Methods: A total of 67 cases of premature infants admitted to our hospital from January 2018 to April 2020 were included, all of whom developed PDA (PDA group). According to the presence or absence of symptoms, they were divided into the symptomatic group (28 cases) and the asymptomatic group (39 cases).In addition, 62 premature infants without PDA who were born in our hospital during the same period were selected as the control group. The expression levels of cortisol, BNP, and PGE-2 in infants in different groups and between infants with symptoms and without symptoms were analyzed, along with the risk factors leading to PDA in preterm infants. The value of cortisol, BNP, and PGE-2 in the diagnosis of PDA in premature infants was also analyzed.Results: Compared with the control group, cortisol in the PDA group was significantly decreased (P<0.05), while the levels of BNP and PGE-2 were significantly increased (P<0.05). The cortisol level in the asymptomatic group was significantly higher than that in the symptomatic group, while the levels of BNP and PGE-2 were opposite, and the differences were statistically significant (P<0.05). Logistic regression analysis showed that birth weight <1,200 g, decreased cortisol, increased BNP, and increased PGE-2 were independent risk factors leading to PDA in preterm infants, and the differences were statistically significant (P<0.05). Receiver operating characteristic (ROC) curve showed that the sensitivity and specificity of cortisol+BNP+PGE-2 in the diagnosis of PDA in premature infants were 75.60% and 73.10%, respectively.The area under the curve (AUC) value was 0.759 (95% CI: 0.611-0.859), which was significantly higher than the AUC values of the 3 tests alone (P<0.05). Conclusions:The expression of cortisol decreased in premature infants with PDA, while the levels of BNP and PGE-2 significantly increased. Dynamic detection of the changes in these levels can provide an important reference for the early diagnosis of PDA and for the assessment of disease progression.

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Patent ductus arteriosus and small for gestational age infants: Treatment approaches and outcomes

Cited by 6 publications

References 25 publications

Application of block matching method-based Echocardiography combined with serum NT-PROBNP level detection in the early prediction of PDA in premature infants

Application of block matching method-based Echocardiography combined with serum NT-PROBNP level detection in the early prediction of PDA in premature infants

Fitness of INTERGROWTH-21st birth weight standards for Chinese-ethnicity babies

Change and clinical significance of serum cortisol, BNP, and PGE-2 levels in premature infants with patent ductus arteriosus

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