A Cross-sectional Descriptive Study of Symptomatic Patent Ductus Arteriosus in Very Low Birth Weight Neonates

Abstract

Abstract Background: Very low birth weight (VLBW) neonates with symptomatic patent ductus arteriosus (PDA) are at increased risk of complications of prematurity. Objective: To describe the incidence and clinical conditions associated with symptomatic PDA in VLBW neonates. Methods: This was a cross-sectional, retrospective, descriptive study of VLBW neonates admitted to a large urban public hospital between 1 January 2013 and 30 June 2016. Survival outcome and characteristics between VLBW neonates with PDA and those without PDA were compared and analysed using univariate analysis. Binary logistic regression was used to obtain characteristics most significantly associated with symptomatic PDA. Results: There were 1844 eligible neonates of whom 308 were excluded (24 major birth defects, 34 missing records and 250 discharged or died in the first 72 h). There was echocardiographic confirmation of symptomatic PDA in 184 (11.9%) of the remaining neonates. Blood transfusion (odds ratio 3.180, 95% confidence interval 1.578–6.405, p = 0.001), surfactant therapy (3.190, 1.215–8.381, p = 0.019), intermittent positive pressure ventilation (2.746, 1.703–4.429, p < 0.001) and age on discharge (1.028, 1.017–1.039, p < 0.001) were most associated with increased incidence of PDA. Antenatal steroid use (0.459, 0.285–0.738, p = 0.001) was associated with a decreased incidence of PDA. The majority of symptomatic PDAs received oral ibuprofen (n = 110) compared to conservative treatment (n = 60) and oral indomethacin (n = 5). A few had surgical ligation (n = 9). There was no statistical significance in mortality rates between neonates with and without PDA. Conclusion: Symptomatic PDA occurred in a minority of VLBW neonates and was not associated with an increased risk of mortality.