PREDICTION OF SYMPTOMATIC PATENT DUCTUS ARTERIOSUS (sPDA) FROM PERINATAL RISK FACTORS

Abstract

In order to quantify the relationship between perinatal risk factors and the incidence of symptomatic PDA (requiring digoxin) in preterm infants, linear discriminant analysis was used to devise a predictive scoring system. Using a training set of 100 consecutively admitted infants (44 with sPDA) with a birthwelght of 1500 g or less and who lived at least 72 hours, 5 factors were found that correlated significantly (P<.01) with subsequent incidence of sPDA: 1. any continuous distending airway pressure (CDAP) within the first 24 hours of life (r=.71); 2. small forgestational age (SGA) (r=-.62); 3. hyaline membrane disease (HMD) (r=.62); 4. acute intrapartum stress (AIS) (r=.54); 5. birth-weight in grams (r=-.52). Based on the discriminant coefficients, a predictive score for sPDA could be derived for an infant by adding to the birthwelght 466 if the infant was SGA, and subtracting 220, 456, or 104 for the occurrence of CDAP, HMD or AIS, respectively. When training set infants with a score <852 were classified as “sPDA” and >852 as “non-sPDA", 80% were classified accurately. Sequential discriminant analyses adding one factor at a time yielded improved classification with each step, substantiating the independent discriminating power of each factor. This model may help identify population differences that are thought to contribute to the variable incidence of sPDA between neonatal intensive care centers, and may prove useful in clinical management and teaching.

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Cotton, R., Lindstrom, D. & Stahlman, M. PREDICTION OF SYMPTOMATIC PATENT DUCTUS ARTERIOSUS (sPDA) FROM PERINATAL RISK FACTORS. Pediatr Res 11, 387 (1977). https://doi.org/10.1203/00006450-197704000-00108

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