Clinical laboratory and anamnestic features of extremely premature newborns with hemodynamically significant arterial duct

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Abstract

Objective. To study the clinical laboratory and anamnestic features in extremely premature newborns with hemodynamically significant functioning arterial duct.

Prematurity is an actual medical and social problem. Functioning arterial duct (FAD) is one of the most significant manifestations of cardiovascular system immaturity in extremely premature newborns.

Materials and methods. The study involved the data from 100 premature newborns (birth body mass 500 to 1500 and gestation age <32 weeks), who were born from October 2018 to April 2020 in Perm Regional Perinatal Center. According to standard EchoCG criteria, patients were divided into 2 groups: main group – patients with hemodynamically significant open arterial duct (HS FAD) and comparison group – those with insignificant FAD. All clinical laboratory studies were implemented on the third day of life.

Results. The main group included 46 extremely premature infants with hemodynamically significant FAD, the comparison group – 54 with hemodynamically insignificant FAD. Parity of labor reliably differed: 73.9 % (34/46) of mothers in the main group were primiparas and 40.7 % (22/54) in the comparison group, (p = 0.001). Pregnancy course with the threat of miscarriage was significantly more often noted in the main group – 73.9 % (34/46) of cases and 38.9 % (21/54) of cases in the comparison group, (р = 0.001). Comparative analysis of peripheral blood indices detected significant differences in thrombocytopenia, which occurred more often in the main group than in the comparison group: 52.2 % (24/46) versus 29.6 % (16/54), (p = 0.022).

Conclusions. Significant differences were established according to the parity of labor, threat of miscarriage. The threat of miscarriage reliably rises chances for giving birth to a child with HS FAD by 3.5 times, in the first labor the chance for giving birth to a child with HS FAD is increased by 4.3 times. Thrombocytopenia occurred more often in the main group versus the comparison group.

About the authors

Artem A. Porodikov

Sukhanov Federal Center of Cardiovascular Surgery; Perm Regional Perinatal Center Structural division of Perm Regional Clinical Hospital

Author for correspondence.
Email: porodickov.a@yandex.ru
ORCID iD: 0000-0003-3624-3226

cardiovascular surgeon

Russian Federation, Perm

References

  1. Hannah Blencowe, Simon Cousens, Doris Chou, Mikkel Oestergaard, Lale Say, Ann-Beth Moller, Mary Kinney, Joy Lawn. Born too soon: the global epidemiology of 15 million preterm births. Reprod Health 2013; 10 (1): S2. doi: 10.1186/1742-4755-10-S1-S2
  2. Volyanyuk E.V. Hemodynamically significant patent ductus arteriosus in premature infants. Prakticheskaya medicina 2010; 5: 73–75. (in Russian).
  3. Kryuchko D.S., Bajbarina E.N., Rudakova A.A. Patent ductus arteriosus in a premature newborn: neonatologist tactics. Voprosy sovremennoj pediatrii 2011; 10 (1): 58–65 (in Russian).
  4. Protocol for the management of premature infants with a hemodynamically significant functioning ductus arteriosus. Metodicheskie rekomendacii. Pod red. prof. N.N. Volodina, prof. E.N. Bajbarinoj. M. 2009; 34 (in Russian).
  5. Astolfi P., Zonta L.A. Delayed maternity and risk at delivery. Paediatr Perinat Epidemiol 2002; 16 (1): 67–72. doi: 10.1046/j.1365-3016.2002.00375.x
  6. Yogev Y., Melamed N., Bardin R., Tenenbaum-Gavish K., Ben-Shitrit G., Ben-Haroush A. Pregnancy outcome at extremely advanced maternal age. Am J Obstet Gynecol 2010; 203 (6): 558e.1–558-e.7. doi: 10.1016/j.ajog.2010.07.039
  7. Naoko Kozuki, Anne C. C. Lee, Mariangela F. Silveira, Ayesha Sania, Joshua P. Vogel, Linda Adair, Fernando Barros, Laura E. Caulfield et al. The associations of parity and maternal age with small-for-gestational-age, preterm, and neonatal and infant mortality: a meta-analysis. Meta-Analysis BMC Public Health. 2013; 13 (3): S2. doi: 10.1186/1471-2458-13-S3-S2
  8. Farideh Dadkhah, Maryam Kashanian, Giuti Eliasi. A comparison between the pregnancy outcome in women both with or without threatened abortion. Early Human Development 2010; 86 (3): 193–196. doi: 10.1016/j.earlhumdev.2010.02.005
  9. Mulik V., Bethel J., Bhal K. A retrospective population-based study of primigravid women on the potential effect of threatened miscarriage on obsteric outcome. J Obstet Gynaecol 2004; 24 (3): 249–253.
  10. Evans N., Iyer P. Assessment of ductus arteriosus shunt in preterm infants supported by mechanical ventilation: effect of interatrial shunting. J of Pediatrics 1994; 125: 778–785.
  11. Echtler K., Stark K., Lorenz M., Kerstan S., Walch A., Jennen L. et al. Platelets contribute to postnatal occlusion of the ductus arteriosus. Nat Med 2010; 16: 75–82.
  12. Alyamac Dizdar E., Ozdemir R., Sari F.N., Yurttutan S., Gokmen T., Erdeve O. et al. Low platelet count is associated with ductus arteriosus patency in preterm newborns. Early Hum Dev 2012; 88: 813–816.
  13. Kahvecioğlu D., Erdeve O., Akduman H., Uçar T., Alan S., Çakır U., Yıldız D., Atasay B., Arsan S., Atalay S. Influence of platelet count, platelet mass index, and platelet function on the spontaneous closure of ductus arteriosus in the prematurity. Pediatrics & Neonatology 2018; 59 (1): 53–57 doi: 10.1016/j.pedneo.2017.01.006

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2. Figure: The diameter of the ductus arteriosus in the main group and the comparison group

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Copyright (c) 2021 Porodikov A.A.

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