Abstract
Objective
Investigate relevance of diastolic flow abnormalities in celiac trunk (aCT) and middle cerebral artery (aMCA) among preterms with persistent hemodynamically significant patent ductus arteriosus (phsPDA, diameter ≥ 1.5 mm, and age ≥ 7 days).
Study design
Five hundred fifteen echocardiograms from 156 neonates born <28 weeks gestation age (GA) were analyzed retrospectively. Infants with aCT or aMCA at any time were compared with the rest. Separate comparisons were performed for aCT and aMCA. Primary outcome was composite of death, chronic lung disease (CLD), or necrotizing enterocolitis ≥ stage 2. Logistic regression was used to adjust for confounders.
Result
Mean (SD) weight and GA were 820(214) g and 25.2(1.3) weeks. aMCA, but not aCT, was associated with primary outcome [adjusted odds ratio 2.17, 95% CI: 1.01–4.67] and CLD [2.20 (0.99–4.87)].
Conclusion
aMCA may be a valid marker for defining the clinical significance of phsPDA in preterm neonates. aCeT may be of limited value in selecting patients for treatment.
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Acknowledgements
We would like to acknowledge the contribution of Mr Junmin Yang Msc, Statistician, MiCare Research Center, Mount Sinai Hospital, University of Toronto for conducting the statistical analysis for this study and the Canadian Neonatal Network for providing the demographic and clinical outcome data of study infants.
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AJ drafted the research question, AJ and DEW designed the study design and concept, PD, LM, PS, and PJM reviewed and made significant intellectual contribution to the research design. LK, PD, and JP also contributed to research methodology and acquired the study data and prepared files for analysis. AJ, LM, and PS also contributed resources toward the conduct and completion of this project. All authors made significant contribution to the interpretation of the results. AJ and DEW prepared the initial draft of the paper, while PD, LK, JP, LM, PS, and PJM reviewed the paper and provided significant critical revisions. All authors approved the final paper and accept responsibility for all elements of this paper.
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Keusters, L., Purna, J., Deshpande, P. et al. Clinical validity of systemic arterial steal among extremely preterm infants with persistent patent ductus arteriosus. J Perinatol 41, 84–92 (2021). https://doi.org/10.1038/s41372-020-0663-8
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DOI: https://doi.org/10.1038/s41372-020-0663-8
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