456 - Association between Persistent Ductus Arteriosus Severity Score and Treatment Efficacy and Respiratory Outcomes in Extremely Low Birth Weight Infants

Publication Number: 3441.456

Anusha Bai Kalithkar, Holtz Children's Hospital Jackson Memorial Hospital, Miami, FL, United States; Nelson Claure, University of Miami Leonard M. Miller School of Medicine, Miami, FL, United States; Eduardo Bancalari, University of Miami, MIAMI, FL, United States; Sethuraman Swaminathan, University of Miami Miller School of Medicine, Miami, FL, United States

Background: Persistent ductus arteriosus (PDA) is common in extremely low birth weight (ELBW) infants, but management varies due to potential for spontaneous closure and concerns regarding medical therapy. The objective of this study was to evaluate the association of a PDA severity score with treatment and its efficacy and respiratory outcomes.

Objective: 1. To determine the proportion of PDAs across different severity scores that are treated with medications.
2. To evaluate the efficacy of medical treatment in relation to PDA severity score.
3. To assess the impact of PDA severity score on respiratory outcomes.
4. To examine whether treatment of PDA, based on severity score, influence respiratory outcomes.

Design/Methods: We retrospectively analyzed 133 infants born ≤28 weeks’ gestation over 3 years. PDA severity scores were assigned using echocardiographic (echo) criteria (Table 1). Infants were classified as high (≥3) or low ( < 3) score groups. Data collected included pharmacologic therapy, ductal persistence and broncho-pulmonary dysplasia (BPD), with statistical comparisons by chi-square and Mantel-Haenszel analyses.

Results: Among 133 infants, the mean age at initial echo (study 1) was 12 days (range 1-60) and at follow-up (study 2) 33 days (range 9-94). PDA severity scores ≥3 was associated with higher odds of pharmacologic treatment, ductal persistence, and subsequent moderate to severe BPD. Ductal persistence in study 2 also predicted increased BPD risk (see table 1). Pharmacological therapy did not independently reduce BPD risk, once PDA severity and persistence were accounted for.

Conclusion(s): PDA score ≥3 identifies high-risk infants, making echocardiographic scoring a simple tool to stratify ELBW infants and guide management strategies.

Table 1
Table1_PDA_Outcomes.jpegAssociation Between PDA Severity Score and Clinical Outcomes