Developing a Multivariable Prediction Model to Identify a High-Volume Patent Ductus Arteriosus in Neonates Born Extremely Preterm

Amy A. Hobson; Daniel Dagle; Craig G. Rusin; Christopher J. Rhee; Sebastian I. Acosta; Patrick J. McNamara; Danielle R. Rios

doi:10.1016/j.jpeds.2025.114965

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Developing a Multivariable Prediction Model to Identify a High-Volume Patent Ductus Arteriosus in Neonates Born Extremely Preterm

Journal article

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Peer reviewed

Developing a Multivariable Prediction Model to Identify a High-Volume Patent Ductus Arteriosus in Neonates Born Extremely Preterm

Amy A. Hobson, Daniel Dagle, Craig G. Rusin, Christopher J. Rhee, Sebastian I. Acosta, Patrick J. McNamara and Danielle R. Rios

The Journal of pediatrics, Vol.291, 114965

04/2026

DOI: 10.1016/j.jpeds.2025.114965

PMCID: PMC12958464

PMID: 41443570

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https://pubmed.ncbi.nlm.nih.gov/41443570/View

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Abstract

To create a clinical model to predict presence of a high-volume, hemodynamically significant patent ductus arteriosus (PDA) in premature infants. A single-center retrospective cohort analysis was conducted in infants < 27 weeks gestational age who received targeted neonatal echocardiography (TNE) screening for hsPDA. TNEs were categorized as high-volume shunt (score ≥ 9) or no PDA/low-volume shunt (score ≤ 2) using the modified Iowa PDA score. Continuous vital sign data were evaluated in 5-minute increments for the hour preceding each TNE. A Fourier transform of the arterial blood pressure waveform was used to extract features quantifying the waveform shape. Predictor variables were used to create a logistic regression model to classify each 5-minute window as high-volume PDA or no PDA/low-volume shunt. The model included 173 TNEs (37 high-volume shunt,136 no PDA/low-volume shunt) from 90 patients. Mean airway pressure was higher in the high-volume shunt group (p<0.01), but other variables were similar. Once the best model was identified, further training 1,000 times resulted in a mean testing area under the curve of 0.8891 (95% confidence interval 0.8858, 0.8924). Identification of a high-volume PDA shunt is possible with high accuracy using logistic regression modeling. Further work should focus on identification of moderate-volume shunts and correlation with clinical outcomes.

neonatal hemodynamics

shunt volume

targeted neonatal echocardiography

Details

Title: Subtitle: Developing a Multivariable Prediction Model to Identify a High-Volume Patent Ductus Arteriosus in Neonates Born Extremely Preterm
Creators: Amy A. Hobson - University of Iowa, Department of Pediatrics, Division of Neonatology, Iowa City, IA
Daniel Dagle - University of Iowa, Department of Pediatrics, Division of Neonatology, Iowa City, IA
Craig G. Rusin - Baylor College of Medicine
Christopher J. Rhee - Baylor College of Medicine
Sebastian I. Acosta - Baylor College of Medicine
Patrick J. McNamara - University of Iowa
Danielle R. Rios - University of Iowa, Department of Pediatrics, Division of Neonatology, Iowa City, IA
Resource Type: Journal article
Publication Details: The Journal of pediatrics, Vol.291, 114965
DOI: 10.1016/j.jpeds.2025.114965
PMID: 41443570
PMCID: PMC12958464
NLM abbreviation: J Pediatr
ISSN: 0022-3476
eISSN: 1097-6833
Publisher: Elsevier Inc
Language: English
Electronic publication date: 12/22/2025
Date published: 04/2026
Academic Unit: Stead Family Department of Pediatrics; Neonatology
Record Identifier: 9985093887702771

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