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Background <p>We evaluated if the number of days of exposure to a hemodynamically significant patent ductus arteriosus (hsPDA) is associated with bronchopulmonary dysplasia (BPD) and/or mortality in preterm infants.</p> Methods <p>We conducted a retrospective cohort study of preterm infants (birth weight ≤ 1500 g or gestational age &lt; 30 weeks), admitted between January 2017 to December 2022. HsPDA was defined using Neonatologist Performed Echocardiography criteria. Logistic regression was used to assess the relationship between the duration of hsPDA and BPD/death. Additional analyses explored non-linear associations using penalized splines and quadratic functions.</p> Results <p>We included 424 neonates: 204 developed BPD/death. The duration of hsPDA was associated to increased risk of BPD/death (OR = 1.67, 95% CI 1.17–2.56, <i>p </i>&lt; 0.001), adjusted for birth weight, 5’ APGAR score, IVH, durations of mechanical and non-invasive ventilation. We found a progressive increase in the OR for BPD/death during the first week of exposure, followed by a plateau.</p> Conclusion <p>The duration of exposure to hsPDA is associated with adverse neonatal outcomes, (BPD/ death). The risk progressively increases during the first week of exposure followed by a plateau. These findings suggest that the first week of exposure may represent a critical window of opportunity.</p> Impact <p><UnorderedList Mark="Bullet"> <ItemContent> <p>The duration of exposure to a hemodynamically significant PDA is associated with an increased risk of BPD/death. This risk progressively rises during the first week of exposure and then plateaus thereafter.</p> </ItemContent> <ItemContent> <p>This study explores the association between BPD/death and the duration of exposure to a hemodynamically significant PDA, longitudinally assessed using a comprehensive echocardiographic protocol.</p> </ItemContent> <ItemContent> <p>The findings suggest the first week of exposure to a hemodynamically significant PDA is a critical window for interventions to impact outcomes. Future research should focus on identifying high-risk population and developing targeted treatments during this pivotal period.</p> </ItemContent> </UnorderedList></p>

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Association of patent ductus arteriosus duration with bronchopulmonary dysplasia and mortality: a cohort study

  • 期刊论文

  • 发表日期：

    2025年5月6日

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  • Elena Bonafiglia,
  • Simone Garzon,
  • Nicola Forte,
  • Mariachiara Bosco,
  • Matteo Ciuffreda,
  • Alessandra Cristofaletti,
  • Stiljan Hoxha,
  • Renzo Beghini,
  • Stefano Uccella,
  • Leonardo Gottin,
  • Giovanni Battista Luciani,
  • Mariela Ventola,
  • Benjamim Ficial

摘要

Background

We evaluated if the number of days of exposure to a hemodynamically significant patent ductus arteriosus (hsPDA) is associated with bronchopulmonary dysplasia (BPD) and/or mortality in preterm infants.

Methods

We conducted a retrospective cohort study of preterm infants (birth weight ≤ 1500 g or gestational age < 30 weeks), admitted between January 2017 to December 2022. HsPDA was defined using Neonatologist Performed Echocardiography criteria. Logistic regression was used to assess the relationship between the duration of hsPDA and BPD/death. Additional analyses explored non-linear associations using penalized splines and quadratic functions.

Results

We included 424 neonates: 204 developed BPD/death. The duration of hsPDA was associated to increased risk of BPD/death (OR = 1.67, 95% CI 1.17–2.56, p < 0.001), adjusted for birth weight, 5’ APGAR score, IVH, durations of mechanical and non-invasive ventilation. We found a progressive increase in the OR for BPD/death during the first week of exposure, followed by a plateau.

Conclusion

The duration of exposure to hsPDA is associated with adverse neonatal outcomes, (BPD/ death). The risk progressively increases during the first week of exposure followed by a plateau. These findings suggest that the first week of exposure may represent a critical window of opportunity.

Impact

The duration of exposure to a hemodynamically significant PDA is associated with an increased risk of BPD/death. This risk progressively rises during the first week of exposure and then plateaus thereafter.

This study explores the association between BPD/death and the duration of exposure to a hemodynamically significant PDA, longitudinally assessed using a comprehensive echocardiographic protocol.

The findings suggest the first week of exposure to a hemodynamically significant PDA is a critical window for interventions to impact outcomes. Future research should focus on identifying high-risk population and developing targeted treatments during this pivotal period.