Patent Ductus Arteriosus: Perinatal Risk Factors

Nizarali, Zahara

doi:10.4172/2167-0897.1000109

Cited by 13 publications

(21 citation statements)

References 16 publications

(13 reference statements)

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“…Hypoxia and low Apgar scores were associated with increased incidence of PDA [16,59]. Compared to preterm infants without PDA, Group1compared to Group 2 in the present study had significantly lower mean Apgar scores at 1 and 10 minutes, lower scores at 5 minutes, and similar scores at twenty minutes.…”

Section: Patent Ductus Arteriosus Associated Risk Factors and Clinicsupporting

confidence: 41%

“…Prenatal corticosteroid prophylaxis decreases the risk for PDA [14,16,49,54,55], even if administered after chorioamnionitis [24]. In the present study, similar proportions of infants with and without PDA received prenatal corticosteroids, and even if more infants received a complete course, the difference between the two groups was not significant p>0.050.…”

Section: Patent Ductus Arteriosus Associated Risk Factors and Cliniccontrasting

confidence: 41%

“…[ [14,16]. Nor was any difference found between infants with and without PDA when comparing the mean ponderal index and the proportions of SGA infants even though SGA was reported in other studies as a risk factor for PDA [27,49].…”

Section: Patent Ductus Arteriosus Associated Risk Factors and Clinicmentioning

confidence: 98%

“…Sometimes PDA accompanies congenital ductal-dependent heart defects and closure of the PDA soon after birth may precipitate clinical deterioration [12]. In premature infants, PDA incidence is inversely associated with gestational age (GA) and birth weight (BW), the incidence varying between 20-70% in very low birth weight infants (VLBW) [3,6,8,[13][14][15][16][17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

“…Multiple risk factors have been described in association with PDA such as lower GA and BW [14][15][16]21,22], chorioamnionitis and neonatal sepsis, [3,15,[22][23][24][25], maternal diabetes mellitus, [14,26] antepartum hemorrhage, multiple pregnancy, male gender [14], small for gestational age (SGA), [27] lower Apgar scores, need for resuscitation at birth, asphyxia [16], severe respiratory distress syndrome (RDS) [16,22,28,29], excessive fluid administration during the first days of life [30], Furosemide administration [31], decreased platelets number during the first day of life [22,32], oxygen administration [16], lower oxygen saturation targets [33,34], surfactant administration [16,28,35,36], increased duration of mechanical ventilation and respiratory support [22], metabolic acidosis [16], phototherapy [37], and high altitude [6].…”

Section: Introductionmentioning

confidence: 99%

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Persistent Ductus Arteriosus in Critically Ill Preterm Infants

Ognean

Boantă

Kovacs

et al. 2016

The Journal of Critical Care Medicine

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Introduction: Persistent ductus arteriosus (PDA) is found with increased incidence in preterm infants, significantly affecting neonatal morbidity and mortality rates. Aim: To evaluate the association between the presence of PDA and the severity of clinical condition at birth in critically ill preterm infants, with gestational ages (GA) ≤ 32 weeks and severe respiratory distress. Methods: All preterm infants with GA ≤ 32 weeks admitted to the neonatal intensive care unit (NICU) of the Clinical County Emergency Hospital, Sibiu between 1 January 2010 and 31 December 2015 were included in the study. These were categorized as Group 1 [Preterm infants with PDA; n=154] and Group 2 [Preterm infants without PDA; n=186]. Epidemiological and clinical data were collected in the National Registry for Respiratory Distress Syndrome for all children, and data related to prenatal period, clinical characteristics at birth i.e GA, weight, gender, Apgar scores, and clinical features such as resuscitation at birth, surfactant administration, need and duration of respiratory support, neonatal sepsis, complications associated with prematurity, and death, were analyzed. Results: Group 1 infants had significantly lower GA and birth weights, were more often out born (p=0.049, HR 1.69), and had significantly lower Apgar scores at 1 and 10 minutes (p=0.022, p=0.000). They presented a significantly higher need for surfactant administration (42.9% vs 24.7%, p<0.0001) and respiratory support (96.8% vs 90.3%, HR 3.19, p=0.019 for need of CPAP and 22.1% vs 10.8%, HR 2.35, p=0.004 for mechanical ventilation). Duration of respiratory support was also significantly higher in the Group 1 (7.6%±7.5 vs. 5.1±3.8 days, p<0.0001 for CPAP and 20.1±22.5 vs. 12.0±15.7 days, p<0.0001 for mechanical ventilation). Conclusion:In very preterm infants, PDA may be associated with a critical clinical condition leading to serious complications. The presence of PDA after the seventh day of life was associated with an increased need for respiratory support, both CPAP and mechanical ventilation, increased severity of the respiratory distress syndrome, requiring a longer duration of respiratory support, and increased the hospitalization length. In very preterm infants, PDA presence was also associated with a higher rate of severe complications and death, indicating the need for a careful and proper management of these critical cases in neonatal intensive care units.

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Section: Patent Ductus Arteriosus Associated Risk Factors and Clinicsupporting

confidence: 41%

Section: Patent Ductus Arteriosus Associated Risk Factors and Cliniccontrasting

confidence: 41%

Section: Patent Ductus Arteriosus Associated Risk Factors and Clinicmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Persistent Ductus Arteriosus in Critically Ill Preterm Infants

Ognean

Boantă

Kovacs

et al. 2016

The Journal of Critical Care Medicine

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Fresh Frozen Plasma Transfusion: An Independent Risk Factor for Hemodynamically Significant Patent Ductus Arteriosus in Premature Infants

et al. 2021

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Objective The incidence of patent ductus arteriosus (PDA), a major complication of prematurity, may be reduced by restricting fluid administration. Prophylactic fresh frozen plasma (FFP) transfusion may reduce the incidence of intraventricular hemorrhage in these infants, but risks transfusion-related volume overload. We conducted a retrospective study to investigate whether FFP transfusion is a risk factor for hemodynamically significant PDA (hsPDA) in very low birth weight (BW) premature infants. Study Design From January 2009 to December 2014, 102 premature infants with gestational age (GA) less than or equal to 30 weeks were admitted to a level III neonatal intensive care unit, and 88 patients were enrolled. Patients were further divided into non-hsPDA (n = 29) and hsPDA groups (n = 59). We retrospectively reviewed demographic characteristics and various perinatal and postnatal variables. Univariate and multivariable analyses were performed to identify risk factors for hsPDA. Results Compared with non-hsPDA patients, hsPDA patients had lower mean BW and GA, a higher incidence of severe respiratory distress symptoms, perinatal infection, use of surfactant, and need for FFP transfusion. However, multivariable logistic regression analysis showed that only FFP transfusion remained an independent risk factor for hsPDA (adjusted odds ratio = 3.880, 95% confidence interval: 1.214–12.402, p = 0.022) after adjusting for confounding factors. Conclusion FFP transfusion is a significant risk factor for the subsequent development of hsPDA in our study population. FFP transfusion may complicate the fluid management of premature infants and increase the risk of hsPDA. Key Points

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