The predictive value of platelet associated indicators on hemodynamically significant patent ductus arteriosus in preterm infants

Abstract

Objective To study the predictive value of platelet index on hemodynamically significant patent ductus arteriosus (hsPDA) in preterm infants. Method The data of 120 preterm infants born between January 2015 and December 2016 were retrospective analyzed, including 60 cases of non-hsPDA (nhsPDA) group and 60 cases of hsPDA group. The clinical features and platelet associated indicators between nhsPDA group and nhsPDA group were compared. Multivariate Logistic regression was used to analyze the effects of various factors on the occurrence of hsPDA. Receiver operating characteristic (ROC) curve was used to evaluate the early predictive value of platelet associated indicators for hsPDA. Result The hsPDA group had statistically significant differences in many parameters (P<0.05) comparing with the nhsPDA group, including smaller gestational age, lower birth weight and Apgar′s score (1min and 5min), lower proportion of cesarean section and preeclampsia, lower mean platelet volume and platelet distribution width (PDW), bigger PDA diameter and diameter2/birth weight, more serious respiratory distress syndrome, and a higher rate of pulmonary surfactant use. Multivariate Logistic regression analysis indicated that the risk of hsPDA was increased as the PDW decreased (OR=1.240, 95%CI 1.011~1.521). The ROC curve analysis showed that the best diagnostic value of PDW was 12.9%, and the sensitivity of early prediction of hsPDA was about 53.3%, and the specificity was 78.3%. Conclusion PDW has certain early predictive value for hsPDA in preterm infants. Preterm infants with PDW<12.9% need to be monitored closely for the occurrence of hsPDA. Key words: Ductus arteriosus, patent; Hemodynamics; Blood platelets; Infant, premature