A Major Cause of Mortality and Morbidity of Very Low Birth Weight Infants: Patent Ductus Arteriosus

Introduction: Patent Ductus Arteriosus (PDA), a cardiac pathology commonly seen in preterm infants, has negative effects on mortality and morbidity. Persistent patency of PDA is positively correlated with respiratory distress syndrome (RDS), prolonged respiratory support, pulmonary hemorrhage, broncopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), intraventricular hemorrhage, renal failure, neurodevelopmental impairment (cerebral palsy), retinopathy of prematurity and death. The standard treatment regimen is to close symptomatic PDA and cyclooxygenase inhibitors such as indomethacin, ibuprofen are the first choises. Our aim in this study is to report PDA rate, treatment and complications in premature infants. Materials and Methods: This study retrospectively enrolled 103 infants born < 33 gestational weeks, without any major congenital anomaly or congenital heart defects between January 2010-November 2011. Echocardiograms was performed in the first week. PDA related pulmonary hemorrhage, NEC, BPD, ROP and death were demonstrated. Results: Among of 103 infants, 45 were male and 58 were female. Seventy infants were born with cesarian section and 33 were born with normal labor. The mean gestational week was 29.7 +/- 2.2, the mean gestational week of infants with PDA was 28.8 +/- 2.3. The mean birth weight of infants was 1323 +/- 375 grams. The mean Apgar score was 7.25 +/- 1.83, the scores of infants with patent ductus arteriosus were significantly low (6.7 +/- 1.9). Echocardiography was performed on the mean of 4.8 +/- 4.4 days, PDA was determined in 48 of 103 infants (% 46). The mean of birth weight of infants with persistant PDA was 1162 +/- 351 grams, it was 1465 +/- 340 g in the closed group. The rate of pulmonary hemorrhage, NEC, BPD, ROP and death was significantly higher in infants with PDA compared with infants having ductal closure (p<0.05). Conclusion: The early closure of PDA in very low birth weight infants will reduce both mortality and early or late morbidities.