Risk Factors for Persistent Ductus Arteriosus Patency during Indomethacin Treatment

Chorne, Nancy; Jegatheesan, Priya; Lin, Emil T.; Shi, Robert; Clyman, Ronald I.

doi:10.1016/j.jpeds.2007.05.007

Cited by 73 publications

(57 citation statements)

References 52 publications

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“…28,29 PDA persistence was also largely heritable in our analysis, a finding that is consistent with a significant contribution of individual's ethnic background to susceptibility. 30 PDA closure mainly depends on circulating levels of endogenous prostaglandins, produced by cyclooxygenase (COX), in addition to nitric oxide (NO) which mediates ductal relaxation in highly immature neonates. 31 So far, only one study has reported an association between an A1166C polymorphism in the angiotensin II type 1 receptor gene and PDA persistence, although the mechanism underlying this association is unclear.…”

Section: Discussionmentioning

confidence: 99%

Heritability of Bronchopulmonary Dysplasia, Defined According to the Consensus Statement of the National Institutes of Health

2008

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Objective-The goal was to determine the magnitude of genetic effects on susceptibility and risk factors for bronchopulmonary dysplasia by using the clinically validated National Institutes of Health consensus definition as a demonstrated proxy for long-term respiratory and neurodevelopmental outcomes in extremely low birth weight infants.Methods-We analyzed clinical data from twin pairs born at ≤30 completed weeks gestation in British Columbia, Canada, between 1993 and 2006. Differences in correlations between monozygotic (MZ) and dizygotic (DZ) twin pairs and model-fitting approaches were used to quantify the relative contribution of genetic, shared environmental and non-shared environmental effects.Results-Among 318 twins of known zygosity, monozygotic twin pair similarities were greater than those observed for dizygotic pairs, which suggest significant heritability for bronchopulmonary dysplasia. Model-fitting analyses confirmed that genetic effects accounted for 82% and 79% of the observed variance in bronchopulmonary dysplasia susceptibility, defined on the basis of the need for supplemental oxygen at 36 weeks or the National Institutes of Health consensus definition, respectively. Variations in rates of hemodynamically significant PDA were largely accounted for by genetic effects, whereas variance in susceptibility to blood-borne bacterial infections was largely attributable environmental factors both common and unique to each infant.Conclusions-Susceptibility to BPD and persistence of PDA are both significantly heritable. Our study strengthens the case for investigating further genetic risk stratification markers useful for predicting the most significant long-term respiratory and neurodevelopmental consequences of bronchopulmonary dysplasia in premature neonates.

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Section: Discussionmentioning

confidence: 99%

Heritability of Bronchopulmonary Dysplasia, Defined According to the Consensus Statement of the National Institutes of Health

2008

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“…5 Furthermore, COX inhibitors are ineffective in ductal closure in as many as 21 to 40% of preterm infants, with~21% of infants with PDA requiring surgical ligation despite having received indomethacin. [6][7][8] Maternal characteristics implicated in persistent ductal patency include lack of exposure to antenatal betamethasone, maternal race, pregnancy-induced hypertension and intrauterine inflammation. [8][9][10] Neonatal characteristics associated with persistence of the ductus include lower GA, respiratory distress syndrome and sepsis.…”

Section: Introductionmentioning

confidence: 99%

“…[6][7][8] Maternal characteristics implicated in persistent ductal patency include lack of exposure to antenatal betamethasone, maternal race, pregnancy-induced hypertension and intrauterine inflammation. [8][9][10] Neonatal characteristics associated with persistence of the ductus include lower GA, respiratory distress syndrome and sepsis. 5,[8][9][10][11][12] Delayed initiation of treatment with indomethacin, larger ductal size and thrombocytopenia have been described in patients whose ductus failed to close with indomethacin treatment.…”

Section: Introductionmentioning

confidence: 99%

“…[8][9][10] Neonatal characteristics associated with persistence of the ductus include lower GA, respiratory distress syndrome and sepsis. 5,[8][9][10][11][12] Delayed initiation of treatment with indomethacin, larger ductal size and thrombocytopenia have been described in patients whose ductus failed to close with indomethacin treatment. 6,13,14 Echtler et al 14 have shown that platelets are involved in functional closure as well as in subsequent remodeling and eventual fibrosis of the ductus in mouse pups.…”

Section: Introductionmentioning

confidence: 99%

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Predictors of successful closure of patent ductus arteriosus with indomethacin

et al. 2015

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“…Gestational age, antenatal glucocorticoid exposure, respiratory distress syndrome (RDS), and race have been reported as independent risk factors affecting ductal closure [6,7,8]. In addition, some prior studies have shown that sPDA is highly familial.…”

Section: Introductionmentioning

confidence: 99%

Very Low Birth Weight Monochorionic Diamniotic Twins as a Risk Factor for Symptomatic Patent Ductus Arteriosus

Yamaguchi

Wada²,

Nagasawa³

et al. 2016

Neonatology

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Background: Some prior studies have shown that symptomatic patent ductus arteriosus (sPDA) is highly familial. Although it is estimated that both genetic and environmental factors may contribute to sPDA, evidence is still lacking. Objective: The aim of this study was to determine the risk factors for sPDA, focusing on the genetic and in utero environment by analyzing very low birth weight (VLBW) singletons and twins. Methods: This retrospective case-control study reviewed the medical records of 445 VLBW infants (25 weeks ≤ gestational age <32 weeks, 600 g ≤ birth weight <1,500 g) and compared the incidence of sPDA among monochorionic diamniotic (MD) twins (n = 65), dichorionic diamniotic (DD) twins (n = 66), and singletons (n = 314). Results: Stepwise multiple regression analysis showed that twin siblings (p = 0.001), gestational week (p < 0.001), antenatal steroid use (p = 0.021), and premature rupture of membranes (p = 0.002) were independent predictors of sPDA. Incidence of sPDA in MD twin siblings was significantly higher than that in singletons (p < 0.01), whereas no significant difference was found between singletons and DD twins or between MD and DD twins. Conclusions: The current results show that being a VLBW MD twin is an independent risk factor for sPDA, and that both genetic and in utero environmental factors may contribute to its development.

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Risk Factors for Persistent Ductus Arteriosus Patency during Indomethacin Treatment

Cited by 73 publications

References 52 publications

Heritability of Bronchopulmonary Dysplasia, Defined According to the Consensus Statement of the National Institutes of Health

Heritability of Bronchopulmonary Dysplasia, Defined According to the Consensus Statement of the National Institutes of Health

Predictors of successful closure of patent ductus arteriosus with indomethacin

Very Low Birth Weight Monochorionic Diamniotic Twins as a Risk Factor for Symptomatic Patent Ductus Arteriosus

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