Abstract:Objective: To analyze the risk factors of hsPDA(hemodynamic significant PDA, hsPDA)and achieve the goal of early diagnosis and appropriate treatment to improve rate of survival. Methods: In January 2017-March 2018 hospitalized in our neonatal heart hospital, super PDA confirmed 140 cases of premature infants, using a retrospective survey method, through the literature, combined with the actual situation of the hospital, were the risk factors of the hemodynamic effects of hsPDA analysis. Results: HsPDA was related to gestational age, birth weight, sex, mother's pregnancy induced hypertension, premature rupture of membranes, placental lesions, amniotic fluid abnormalities, catheter diameter, 1.5-3mm, and fluid intake within 3 days after birth. Gestational age was associated with hsPDA (P<0.05). Birth weight was associated with hsPDA (P<0.05). Multivariate binary logistic regression analysis showed that sex, pregnancy induced hypertension, premature rupture of membranes, placental lesions and abnormal amniotic fluid were independent risk factors for hsPDA, with OR values of 1.173, 1.546, 1.670, 1.814 and 1.702, respectively. There was no correlation between maternal abnormal blood glucose metabolism during pregnancy, prenatal infection and prenatal dexamethasone use and hsPDA (P values were 0.6483, 0.343 and 0.410, respectively). Intrauterine distress (P = 0.8936) and umbilical cord abnormality (P = 0.3433) were not associated with hsPDA. The diameter of PDA catheter ranged from 1.5 mm to 3 mm, which was associated with hsPDA (P<0.05). The diameter of PDA catheter ranged from 1.6 mm to 3 mm, which was associated with hsPDA (P<0.05). The diameter of catheter > 3mm was not associated with hsPDA (P=0.9598). The liquid intake of PDA in hsPDA group and nhsPDA group on the 3rd day after birth was examined by t test. The results showed that the liquid intake on the 1st day (P<0.001), the 2nd day (P<0.001), and the 3rd day (P<0.001) were all correlated with hsPDA (P<0.05). Conclusions: Identifying and avoiding the risk factors of hsPDA is of great significance for improving the survival rate of premature infants and reducing the occurrence of sequelae.
[1] Tashiro J, Wang B, Sola J E, et al.Patent ductus arteriosus ligation in premature infants in the United States[J].Surg Res, 2014, 190(2):613~622. [2] Stevenson J G.Fluid administration in the association of patent ductus arteriosus complicating respiratory distress syndrome[J].Pediatr, 1977, 90(2):257~261. [3] Heuchan A M, Clyman R I.Managing the patent ductus arteriosus: current treatment options[J].Arch Dis Child Fetal Neonatal Ed, 2014, 99(5):431~436. [4] Ohlsson A, Walia R, Shah S S.Ibuprofen for the treatment of patent ductus arteriosus in preterm andor low birth weight infants[J].Cochrane Database Syst Rev, 2013, 27(4):1~153. [5] Oncel M Y, Yurttutan S, Erdeve O, et al.Oral paracetamol versus oral ibuprofen in the management of patent ductus arteriosus in preterm infants: a randomized controlled trial[J].Pediatr, 2014, 164(3):510~514. [6] Weisz D E, More K, McNamara P J, et al.PDA ligation and health outcomes: a meta-analysis[J].Pediatrics, 2014, 133(4):1024~1046.