Abstract Ref Number = APCP1008
FACTORS ASSOCIATED WITH CLOSURE OF DUCTUS ARTERIOSUS
R Adhi Teguh Perma Iskandar,Saidatun Nisa,Rifa Iztihara
Divisi Perinatologi RSUPN Cipto Mangunkusumo
Background : In the newborn, the ductus arteriosus will close spontaneously as the arterial partial oxygen pressure increases and pulmonary vascular resistance decreases. Prevalence of Patent Ductus Arteriosus (PDA) at Cipto Mangunkusumo Hospital in 2017 was about 5.6% from 1524 live births. PDA is one of congenital heart diseases commonly encountered in premature infants and related to newborn morbidity and mortality. The mortality rate is six times higher in persistent PDA than the closed one. There is still no definite factor that can explain why the ductus arteriosus does not close spontaneously even thought medical treatment was given.
Material : This is an observational retrospective study in all babies who born, treated and diagnosed of having PDA in Cipto Mangunkusumo’s Neonatal Ward during January until December 2017. We followed subjects’s medical records for 2 weeks or sooner if the PDA had been closed. The analyzed variables were : gestational age, birth weight, maternal age, history of antenatal corticosteroid, fluid administration during resuscitation, sepsis, use of non-steroid anti-inflammatory drugs (NSAID), Respiratory distress syndrome, PDA’s degree. We also followed their 2 weeks serial echocardiograms result. The exclusion criteria were newborns with other congenital malformations beside PDA or had uncompleted serial echocardiograms. The data ware cathegorical dichotomous and analyzed by Chi-Square test.
Results : There were 75 neonates during that period but 9 subjects are excluded due to congenital malformations and incomplete echocardiogram data. Only two factors that associated with closure of PDA, the factors associated with persistent PDA was birth weight < 1500 grams (OR:9,931, 95% CI:1,203-81,952; P_0,012), and factors associated with closure PDA was the use of NSAID less than 3 days age (OR:0,059, 95% CI:0,007-0,489; P_0,001).
Conclusions : Newborn with birth weight < 1500 grams had higher risk to develop persistent PDA and the use of NSAID in less than 3 days age are associated with closure of ductus arteriosus.
Keywords: Patent Ductus Arteriosus Birth Weight NSAID