The Association between Patent Ductus Arteriosus and Perinatal Infection in A Group of Low Birth Weight Preterm Infants

Gentian  Vyshka; Edmond  Pistulli; Arjan  Hamiti; Sokol  Buba; Alketa  Hoxha; Nita  Kelmendi

IJ Pediatrics

The Scientific Journal of Growth & Development Research Center

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The Association between Patent Ductus Arteriosus and Perinatal Infection in A Group of Low Birth Weight Preterm Infants

Author(s):

Gentian Vyshka^1,*,

Edmond Pistulli²,

Arjan Hamiti³,

Sokol Buba⁴,

Alketa Hoxha⁵,

Nita Kelmendi⁶

IJ Pediatrics:Vol. 24, issue 1; 42-48

Published online:Nov 22, 2013

Article type:Research Article

Received:May 09, 2013

Accepted:Oct 11, 2013

How to Cite:Gentian VyshkaEdmond PistulliArjan HamitiSokol BubaAlketa HoxhaNita Kelmendiet al.The Association between Patent Ductus Arteriosus and Perinatal Infection in A Group of Low Birth Weight Preterm Infants.Iran J Pediatr.24(1):42-48.

Abstract

Objective: Patent ductus arteriosus (PDA) is an extremely common occurrence in very premature infants. Untreated symptomatic PDA may be associated with chronic lung disease. PDA has a major role in neonatal mortality and morbidity. We compared the efficacy and safety of oral versus intravenous ibuprofen for the pharmacological closure of PDA in low birth weight (LBW) preterm infants. Methods: A randomized, single-blinded, controlled study was performed on premature neonates at the neonatal unit, University Hospital for Obstetrics and Gynecology “Koço Gliozheni”, Tirana, Albania from January 2010 to December 2012. The study enrolled 68 preterm infants with a confirmed and significant PDA. The preterm infants received either intravenous or oral ibuprofen randomly as an initial dose of 10 mg/kg, followed by 5 mg/kg at 24 and 48 h. Findings: 36 patients were treated with oral ibuprofen and 32 with intravenous ibuprofen during this period. After the first course of the treatment, the PDA closed in 30 (83.3%) of the patients assigned to the oral ibuprofen group versus 23 (71.8%) of those enrolled in the intravenous ibuprofen group (P=0.355). 15 patiens needed a second treatment course and they all (100%) had clinical signs of infection and positive blood culture. There was no reopening of the ductus after the closure. Conclusion: Our data indicate that, for LBW infants, the rate of early ductal closure was comparable and the adverse effects were fewer with oral ibuprofen in comparison to the intravenous route. Association of PDA with perinatal infection has a negative impact in pharmacological closure of the ductus, increasing the need for a second course of treatment or for surgery.

Keywords

Prematurity

Perinatal Infection

Patent Ductus Arteriosus

Oral Ibuprofen

Intravenous Ibuprofen

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