Abstract
Objective This study aims to characterize population risks for diagnosis, medical treatment,
and surgical ligation of patent ductus arteriosus (PDA) in very low-birth-weight infants.
Study Design Maternal and neonatal data were collected in 40 hospitals in California during 2011
for infants with birth weight ≤ 1,500 g without any congenital malformation, with
a diagnosis of PDA. Multivariable logistic regression was used to determine independent
risks for PDA diagnosis and for surgical ligation.
Results There were 770/1,902 (40.4%) infants diagnosed with PDA. Low birth weight, gestational
age, respiratory distress syndrome, and surfactant administration were associated
with PDA diagnosis. Ligation occurred in 43% of patients with birth weight ≤ 750 g,
in 24% of patients weighing between 715 and 1,000 g, and in 12% of patients weighing
from 1,001 to 1,500 g. Older gestational age (1 week, odds ratio 0.55, 95% confidence
interval 0.48–0.63) and absence of respiratory distress syndrome (odds ratio 0.14,
95% confidence interval 0.03–0.59) were associated with lower ligation risk. The median
hospital ligation rate was 14% (interquartile range 0–38%).
Conclusion Most patients with PDA receive treatment for closure. Practice variation may set
the stage for further exploration of experimental trials.
Keywords
patent ductus arteriosus - ligation - very low birth weight
