Journal article
Exposure to persistent hemodynamically significant patent ductus arteriosus is associated with retinopathy of prematurity
Journal of AAPOS, Vol.28(3), 103923
04/29/2024
DOI: 10.1016/j.jaapos.2024.103923
PMID: 38692561
Abstract
Hemodynamically significant patent ductus arteriosus (hsPDA) shunt may predispose infants to retinopathy of prematurity (ROP) because of its higher preductal cardiac output and blood oxygen content, which may augment ocular oxygen delivery.
A retrospective cohort study of preterm infants, born at <27 weeks’ gestation and admitted at <24h postnatal age to a large quaternary referral was conducted. The primary composite outcome was death at <32 weeks or moderate-to-severe ROP (≥stage 2 or requiring treatment) in either eye. Secondary outcomes included ROP requiring treatment, and any ROP. Univariate analysis of patient characteristics and outcomes was performed as well as logistic regression. A receiver operating characteristics curve was generated for the outcome of ROP ≥stage 2 or requiring treatment.
A total of 91 patients were screened, of whom 86 (54 hsPDA, 32 controls) were eligible for inclusion. hsPDA patients were younger and lighter at birth and had a higher burden of hyperglycemia and respiratory illness. The rates of the composite outcome (death <32 weeks or moderate-to-severe ROP) and of any ROP were more frequent in the hsPDA group. hsPDA shunt exposure was independently associated with development of any ROP among survivors to assessment (P = 0.006). PDA cumulative exposure score of 78 (clinical equivalent = 7 days high-volume shunt exposure) predicts moderate-to-severe ROP with 80% sensitivity and 78% specificity.
Among infants <27 weeks, hsPDA shunt is associated with increased risks of a composite outcome of death or moderate-to-severe ROP, as well as ROP of any stage. Shunt modulation as a strategy to reduce ROP represents a biologically plausible avenue for investigation.
Details
- Title: Subtitle
- Exposure to persistent hemodynamically significant patent ductus arteriosus is associated with retinopathy of prematurity
- Creators
- Alison Ford - University of IowaMadeline Beauchene - University of IowaAmy H. Stanford - University of IowaJonathan M. Klein - University of IowaJohn M. Dagle - University of IowaDanielle R. Rios - University of IowaScott A. Larson - University of IowaPatrick J. McNamara - University of IowaRegan E. Giesinger - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Journal of AAPOS, Vol.28(3), 103923
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.jaapos.2024.103923
- PMID
- 38692561
- ISSN
- 1091-8531
- eISSN
- 1528-3933
- Language
- English
- Electronic publication date
- 04/29/2024
- Academic Unit
- Stead Family Department of Pediatrics; Epidemiology; Biochemistry and Molecular Biology; Neonatology; Internal Medicine; Ophthalmology and Visual Sciences
- Record Identifier
- 9984623027402771
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