Patent Ductus Arteriosus Response to Treatment by Course and Associations with Perinatal and Clinical Factors.

Document Type

Article

Publication Date

5-2024

Identifier

DOI: 10.1055/s-0043-1768962

Abstract

OBJECTIVE:  The objective of this study is to examine patent ductus arteriosus (PDA) response by treatment course and investigate associations with postmenstrual age (PMA), chronological age (CA), gestational age (GA), antenatal steroid exposure (ANS), birthweight (BW), weight at treatment initiation (WT), and PDA/left pulmonary artery (LPA) ratio.

STUDY DESIGN:  This is a single-center retrospective cohort study of preterm infants less than 37 weeks' GA born January 1, 2016 to December 31, 2018 who received acetaminophen and/or indomethacin for PDA treatment. Cox proportional hazards regression models were used to determine whether factors of interest were associated with PDA response to medical treatment.

RESULTS:  In total, 289 treatment courses were administered to 132 infants. Thirty-one (23%) infants experienced treatment-associated PDA closure. Ninety-four (71%) infants had evidence of PDA constriction following any treatment course. Ultimately, 84 (64%) infants experienced definitive PDA closure. For each 7-day increase in CA at the time of treatment initiation, the PDA was 59% less likely to close (p = 0.01). For every 0.1 increase in the PDA/LPA ratio, the PDA was 19% less likely to close in response to treatment.

CONCLUSION:  In this cohort, PDA closure is independent of PMA, GA, ANS, BW, and WT; however, CA at treatment initiation predicted both treatment-associated PDA closure and PDA response (i.e., constriction or closure), and PDA/LPA ratio was associated with treatment-associated closure. Most infants experienced PDA constriction rather than closure, despite receiving up to four treatment courses.

KEY POINTS: · Detailed PDA responses for up to four treatment courses provide a novel perspective.. · Chronological age at the start of treatment predicted treatment-associated PDA closure and response.. · For each 7-day increase in chronological age, the PDA was 59% less likely to close..

Journal Title

American journal of perinatology

Volume

41

Issue

S 01

First Page

1759

Last Page

1768

MeSH Keywords

Humans; Ductus Arteriosus, Patent; Retrospective Studies; Indomethacin; Infant, Newborn; Female; Male; Acetaminophen; Gestational Age; Infant, Premature; Proportional Hazards Models; Birth Weight; Treatment Outcome

Keywords

Patent Ductus Arteriosus; Retrospective Studies; Indomethacin; Acetaminophen; Gestational Age; Proportional Hazards Models; Birth Weight; Treatment Outcome

Link to Full Text
Library Record

Share

COinS