Document Type

Poster

Publication Date

4-18-2024

Abstract

Background: The patent ductus arteriosus (PDA) is a common complication of prematurity that affects the majority of extremely preterm infants. In epidemiological studies, babies with a persistent PDA had increased rates of interventricular hemorrhage, bronchopulmonary dysplasia (BPD), necrotizing enterocolitis, and cerebral palsy. However, numerous clinical trials have demonstrated no improvement in outcomes with medical treatment of the PDA. However, the reliability of these studies has been called into question becaues the majority use size alone to determine hemodynamic significance of the ductus and did not include babies at the youngest gestational ages. It has been theorized that using a more targeted approach would lead to improved outcomes, but this approach has not yet been widely studied and the few studies that exist used targeted neonatal echocardiography which is not yet widely available

Methods: A retrospective cohort study is underway looking at babies born before 28 weeks gestation. For all babies, all echocardiograms with a left-right shunting PDA are analyzed and given a score based on several parameters. The risk ratio for moderate to severe BPD or death and for pulmonary hypertension requiring treatment was then calculated using several different cut-off scores.

Results: A cut-off score of 3, 4, and 5 were analyzed. For all cut-offs there was a non-statistically significant increase in the risk of moderate-severe bronchopulmonary dysplasia or death in babies with exposure to a hemodynamically significant PDA. For a cut-off of 3 and 4 there was a non-statistically significant increase in the risk for pulmonary hypertension requiring treatment but there was a small, non-statistically significant decrease with a cut-off score of 5.

Conclusion: More data is needed to determine whether this scoring system can be used to predict which babies with a PDA are at increased risk for bronchopulmonary dysplasia.

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