title: Predictors of bronchopulmonary dysplasia or death in premature infants with a patent ductus arteriosus.
abstract: BACKGROUND
  Preterm infants with a patent ductus arteriosus (PDA) are at risk for death or development of bronchopulmonary dysplasia (BPD). However, PDA treatment remains controversial. We investigated if PDA treatment and other clinical or echocardiographic (ECHO) factors were associated with the development of death or BPD.
  
  
  METHODS
  We retrospectively studied clinical and ECHO characteristics of preterm infants with birth weight <1,500 g and ECHO diagnosis of a PDA. Logistic regression and classification and regression tree analyses were performed to assess variables associated with the combined outcome of death or BPD.
  
  
  RESULTS
  Of 187 preterm infants with a PDA, 75% were treated with indomethacin or surgical ligation and 25% were managed conservatively. Death or BPD occurred in 80 (43%) infants. The results of logistic regression analyses showed that lower gestational age (odds ratio (OR): 0.5), earlier year of birth during the study period (OR: 0.9), and larger ductal diameter (OR: 4.3) were associated with the decision to treat the PDA, whereas gestational age was the only variable associated with death or BPD (OR: 0.6; 95% confidence interval: 0.5-0.8).
  
  
  CONCLUSIONS
  Only lower gestational age and not PDA treatment or ECHO score was associated with the adverse outcome of death or BPD. Further investigation of PDA management strategies and effects on adverse outcomes of prematurity is needed.
authors.affiliation: Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California.
authors.forename: Valerie Y
authors.initials: VY
authors.lastname: Chock
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Punn
authors.affiliation: Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California.
authors.forename: Anushri
authors.initials: A
authors.lastname: Oza
authors.affiliation: Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California.
authors.forename: William E
authors.initials: WE
authors.lastname: Benitz
authors.affiliation: Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California.
authors.forename: Krisa P
authors.initials: KP
authors.lastname: Van Meurs
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California.
authors.forename: Alice S
authors.initials: AS
authors.lastname: Whittemore
authors.affiliation: Department of Health Research and Policy, Stanford University School of Medicine, Palo Alto, California.
authors.forename: Fariborz
authors.initials: F
authors.lastname: Behzadian
authors.affiliation: Department of Health Research and Policy, Stanford University School of Medicine, Palo Alto, California.
authors.forename: Norman H
authors.initials: NH
authors.lastname: Silverman
mesh_terms: D001997:Bronchopulmonary Dysplasia / Q000150:complications / Q000453:epidemiology* / Q000401:mortality; D004374:Ductus Arteriosus, Patent / Q000139:chemically induced*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature