Management of preterm infants and incidence of patent ductus arteriosus

• Published in: Journal of Iwate Medical Assiociation Vol. 71; no. 5; pp. 201 - 212
• Main Authors: Tsuchiya, Shigekuni, Yoshida, Taro, Matsumoto, Atsushi, Oyama, Kotaro, Takashimizu, Nao, Konishi, Yu, Toya, Yukiko, Ito, Ai, Sotodate, Genichiro, Toyoshima, Hiroshi
• Format: Journal Article
• Language: English
• Published: Iwate Medical Association 01.12.2019
• Subjects: left atrium/aortic root ratio; left pulmonary artery mean diastolic velocity/peak systolic velocity ratio; patent ductus arteriosus; respiratory distress syndrome; serum osmolality
• ISSN: 0021-3284; 2434-0855
• DOI: 10.24750/iwateishi.71.5_201

The effect of different methods of perinatal management for patent ductus arteriosus ‹PDA) occurrence is unknown. Therefore, we compared methods of perinatal management and PDA incidence in preterm infants before and after the introduction of early aggressive nutrition ‹EAN› in our institution. Infants ‹gestational age <34 weeks› who were admitted as inpatients between 2006 and 2008 ‹no EAN, period A) and between 2012 and 2014 ‹EAN, period B› were assessed. Maternal and neonatal factors affecting PDA incidence were investigated. Compared to period A, infant immaturity was more severe and the PDA incidence was higher in period B. More severe immaturity and a higher rate of concomitant respiratory distress syndrome ‹RDS› were noted in infants who developed PDA, both in periods A and B. Multiple logistic regression analysis showed that PDA onset was associated with the presence or absence of RDS, gestational age, and echocardiographic indicators immediately after birth. Despite changes in our institution’s perinatal management, the incidence of PDA was unaffected, with infant immaturity being the most important PDA risk factor. Our results indicate that echocardiographic indicators immediately after birth could be used to predict PDA onset in preterm infants with a low gestational age and RDS.