Patent ductus arteriosus (PDA) is a frequent cardiovascular problem in preterm infants.
The goal of this study was to evaluate the management and outcomes of hemodynamically significant PDA (HS-PDA) in a level 3 Neonatal Intensive Care Unit (NICU) and to identify possible risk factors and associated morbidities.
A retrospective study including all newborns (NB) < 30 weeks of gestation admitted with PDA and a comparative study between HS and non-HS PDA was conducted. Data were collected from clinical records between January 2010 and December 2018.
A total of 143 NB was found, 103 HS-PDA and 40 non-HS-PDA.
In 6.8% HS-PDA was managed exclusively with fluid restriction while 93,2% needed medical or surgical (n=9) treatment.
HS-PDA was more frequent in extreme preterm infants (p=0.03) and in NB needing endotracheal intubation in resuscitation at birth (p<0.001).
Respiratory distress syndrome (p=0.006), surfactant administration (p<0.001) and mechanical ventilation > 7 days (p<0.001) were higher in the HS-PDA group
Anemia with transfusion criteria (p=0,014), intra-periventricular hemorrhage (p=0.019) and acute renal injury (p=0.003) were more common in the HS-PDA group.
Hospitalization for >100 days (p=0,039) and mortality (p=0.019) were higher in HS-PDA group.
At the six-month follow up, 2 HS-PDA were referred for surgical ligation.
Immaturity per se, as expected, was associated with HS-PDA with a higher incidence in extreme preterm infants.
In this study, most of the cases were managed with medical treatment.
HS-PDA was associated with worse clinical outcomes leading to higher mortality rates in preterm infants.