Risk factors for persistent ductus arteriosus patency during indomethacin treatment.
OBJECTIVE
To test the hypothesis that patent ductus arteriosus that fail to close with prostaglandin inhibition may be regulated by mechanisms that act independently of prostaglandin production.


METHODS
We examined a cohort of 446 infants who were treated with indomethacin (within 15 hours of birth) to inhibit prostaglandin production. We used multiple logistic regression modeling to determine which perinatal/neonatal variables were most closely associated with the persistence of ductus patency in the presence of diminished prostaglandin production.


RESULTS
We identified 4 variables (immature gestational age, lack of exposure to antenatal betamethasone, severity of respiratory distress, and Caucasian race) that were significantly and independently associated with the degree of ductus patency.


CONCLUSIONS
Gestational age, antenatal glucocorticoid exposure, respiratory distress, and race are independent risk factors that appear to affect ductus closure even when indomethacin has been used to inhibit prostaglandin production. Future studies of these risk factors may identify new potential targets for patent ductus arteriosus treatment.
Cardiovascular Research Institute and Department of Pediatrics, University of California, San Francisco, California, USA.
Nancy
N
Chorne
Priya
P
Jegatheesan
Emil
E
Lin
Robert
R
Shi
Ronald I
RI
Clyman
D001623:Betamethasone / Q000627:therapeutic use; D015331:Cohort Studies; D004374:Ductus Arteriosus, Patent / Q000188:drug therapy*; D005865:Gestational Age; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use*; D007231:Infant, Newborn; D011448:Prostaglandin Antagonists / Q000627:therapeutic use*; D044469:Racial Groups; D012127:Respiratory Distress Syndrome, Newborn / Q000150:complications; D012307:Risk Factors
D005938:Glucocorticoids; D011448:Prostaglandin Antagonists; D001623:Betamethasone; D007213:Indomethacin