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Arch Dis Child Fetal Neonatal Ed. 2013 Nov;98(6):F505-10. doi: 10.1136/archdischild-2013-303816. Epub 2013 Jul 26.

Morbidity and mortality in preterm neonates with patent ductus arteriosus on day 3.

Author information

1
Department of Pediatrics, Herning Regional Hospital, Herning, Denmark.

Abstract

OBJECTIVE:

To assess the association between a patent ductus arteriosus (PDA) on day 3 of life and severe morbidity and mortality.

DESIGN:

Cohort study.

SETTING:

Neonatal Intensive Care Unit, Aarhus University Hospital, Denmark.

PATIENTS:

All neonates with a gestational age less than 32 weeks admitted from 2010 to 2012.

INTERVENTIONS:

All neonates (n=183) were routinely screened with echocardiography for PDA on day 3 of life. Information on baseline characteristics and outcome was collected by structured coding sheets and medical records.

MAIN OUTCOME MEASURES:

The association among PDA diameter and pulmonary haemorrhage, intraventricular haemorrhage (IVH), necrotising enterocolitis, bronchopulmonary dysplasia (BPD), death, and the composite outcome of death or severe morbidity was assessed.

RESULTS:

In neonates, born prior to 28 gestational weeks, a PDA on day 3 of life was associated with a threefold increase in odds of death or severe morbidity compared with neonates without PDA (OR=3.4; CI 1.1 to 11). The odds were highest in neonates with a large PDA (diameter ≥1.5 mm). Neonates with a large PDA were also found to have increased odds of IVH (OR 4.2; CI 1.3 to 14) and BPD (OR 3.7; CI 1.0 to 14) compared with neonates with no PDA.

CONCLUSIONS:

In neonates born with a gestational age below 28 weeks the presence of a PDA on day 3 of life was associated with adverse outcome; this association was even more pronounced with a large PDA. Thus, early echocardiography may facilitate the identification of neonates suitable for a targeted approach to intervention in future randomised controlled trials.

KEYWORDS:

Epidemiology; Neonatology

[Indexed for MEDLINE]

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