2022 Volume 58 Issue 1 Pages 98-104
We conducted logistic regression analysis for symptomatic patent ductus arteriosus（sPDA）in 357 extremely low birth weight infants who were delivered between January 2008 and December 2019, among whom 177 developed sPDA. The infants were admitted to our neonatal intensive care unit and survived to discharge. Symptomatic patent ductus arteriosus, defined as PDA cases in which the condition required indomethacin（or ibuprofen）administration or PDA ligation, with reference to cardiovascular dysfunction scores, was considered the dependent variable. Perinatal factors and acute therapeutic management items were defined as independent variables. In univariate analysis, significant risk factors for sPDA were: short gestational age, low birth weight, first delivery, indomethacin administration to the mother, low Apgar score at 1 min, high pH values in umbilical cord arterial blood, respiratory distress syndrome（RDS）, gastrointestinal perforation, high-frequency ventilation, neonatal volume loading, and catecholamine administration. On the other hand, administration of xanthine drugs within two days of birth was detected as a significant inhibiting factor for sPDA. In multivariate analysis （adjusted odds ratio: 95％ confidence interval; p-value）, administration of xanthine drugs within two days of birth （0.33: 0.16-0.65; p<0.01）, gestational age（+1 week） （0.67: 0.53-0.82; p<0.01）, RDS（1.94: 1.07-3.55; p＝ 0.03）, and catecholamine administration（2.28: 1.19-4.41; p＝0.01）were detected as factors significantly associated with the occurrence of sPDA. The results suggest that early administration of xanthine drugs to extremely low birth weight neonates might suppress the development of sPDA.
