Clinical analysis of risk factors for and complications of patent ductus arteriosus and hemodynamically significant patent ductus arteriosus in premature infants

Objective To study the risk factors for patent ductus arteriosus (PDA), especially hemodynamically significant patent ductus arteriosus (HsPDA) and the related complications. Methods A case-control study was conducted retrospectively on the clinical data of 149 preterm infants hospitalized in our NICU between January 2017 and January 2018. The patients were assigned into HsPDA, nHsPDA and nPDA according to the diagnostic criteria for PDA and HsPDA. The single factor analysis was conducted among observed variables, and then logistic regression was performed to conclude the independent risk factors for PDA/HsPDA. We also analyze the related risk factors of complications with PDA/HsPDA and ductal closure time. Results There were 23 patients in the HsPDA group, 11 patients in the nHsPDA group and 115 patients in the nPDA group, and no statistical significant difference for the general information was found among the three groups (P>0.05). Single factor analysis showed that PDA/HsPDA was significantly associated with gestational age, multiple pregnancy, Apgar scores and birth weight, the difference among the three groups was significantly (P>0.05); the logistic regression analysis showed that multiple pregnancy (P=0.009), and Apgar scores (for ≤3 scores, P=0.010; for 3 to 7 scores, P=0.036) were the independent risk factor for PDA/HsPDA. Among the three kinds of complications, the relationship between intraventricular hemorrhage (IVH) and HsPDA (R₂=0.884), the relationship between retinopathy of prematurity (ROP) and nHsPDA (R₃=0.841) were the most significant, the correlations for IVH was more obvious in the HsPDA group when compared with the nHsPDA group, for ROP was contrary to it. The bronchopulmonary dysplasia (BPD, R₁=1.308, R₂=1.174) and ROP(R₁=1.308, R₂=1.161) showed more significant relationship to the time of ductal closure, especially in the HsPDA. Conclusion Multiplets and lower Apgar scores are the independent risk factors for PDA/HsPDA. IVH and BPD show more significant relationship with HsPDA when compared with nHsPDA. The ductal closure time correlates closely with BPD and ROP.