Echocardiographic predictors of symptomatic patent ductus arteriosus in extremely-low-birth-weight preterm neonates

Objective: Identify echocardiographic parameters at <= 4 day postnatal that predict the subsequent need for closure of a clinically significant patent ductus arteriosus (sPDA) in extremely-low-birth-weight neonates (ELBW). Study Design: Serial echocardiograms obtained in 115 ELBW at <= 10 day postnatal were examined to estimate PDA size using the PDA: left pulmonary artery (LPA) diameter ratio: >= 1 indicated a large PDA, < 1 but >= 0.5 moderate, and < 0.5 small. Sensitivity, specificity, and positive predictive values (PPV) were determined for ELBW < 27 weeks and >= 27 weeks gestational age. Result: Neonates with moderate to large PDA at <= 4 day had 15-times greater likelihood of requiring treatment for sPDA than those with a small PDA (95% confidence interval (CI): 5.6-41). Sensitivity, specificity and PPV of the PDA: LPA at < 27 weeks was 80, 86 and 92%, respectively. Conclusion: A moderate to large PDA determined from the PDA: LPA ratio at <= 4 day postnatal identifies neonates < 27 week gestation who subsequently require closure of a PDA. Journal of Perinatology (2010) 30, 535-539; doi:10.1038/jp.2010.14; published online 25 February 2010