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Volume 4
Journal of Pediatric Care
ISSN: 2471-805X
Page 50
JOINT EVENT
May 07-08, 2018 Frankfurt, Germany
&
3
rd
International Conference on
Pediatrics and Pediatric Surgery
22
nd
Edition of International Conference on
Neonatology and Perinatology
CURRENT BRONCHOPULMONARY DYSPLASIA IN PRETERM CHILDREN WITH THE
PATENT DUCTUS ARTERIOSUS ATAGE OF 3 YEARS
T.K. Mavropulo
1
State Institution "Dnipropetrovsk Medical Academy of the Ministry of Health of Ukraine", Dnipro, Ukraine
A
lthough over the past few decades improvement in perinatal care has increased the survival of very low-birthweight infants,
these newborns continue to suffer from significant morbidities such as bronchopulmonary dysplasia (BPD). Despite the
fact that the hemodynamically significant patent ductus arteriosus (PDA) contributes to formation of BPD (Kaempf et al.,
2013), the role of hemodynamically insignificant (HI) PDA in the course of BPD is insufficiently clear. This study is aiming at
identifying the features of the course of BPD of 1-year-old and 3-year-old children born prematurely, depending on a condition
of PDA. The retrospective analysis of 146 preterm infants (gestation age, 24-32 weeks) with BPD and follow-up during their
first three years of life were performed. Children were divided in three groups depending on a condition of PDA: (i) 58 preterm
infants, in whom PDA was closed independently in the early neonatal period; (ii) 60 preterm infants with hemodynamically
insignificant PDA that required surgical closure of PDA; (iii) 28 preterm infants with hemodynamically significant PDA that
was treated with a surgery at the age of 21.5±1.6 days. Echocardiographic indexes used in assessment of hemodynamically
significant PDA were PDA diameter index to body weight ≥ 1.5mm/kg, ratio of left atrial diameter to aortic root measured
using M-mode echocardiography ≥1.5, diastolic flow pattern (antegrade, absent, retrograde diastolic flow) in systemic arteries
(descending aorta, celiac, superior mesenteric and/or renalis, middle cerebral), resistance index in a. cerebri anterior ≥ 0.8
(Tacy, 2009; Sehgal and McNaMara, 2009; Hajjar, 2005). During the treatment stage in perinatal center, the second group
included more children with severe BPD in comparison to the first group (23.3%, 5.6%, p <0.01). In the comparison groups
of 1-year-old children, the significant differences in the clinical aspects of BPD were not observed. Specifically, 20 to 35% of
children were healthy, about 50% had mild BPD, 15 – 20% had mediate and 5 – 10% had severe BPD. At the age of 3 years,
the first group included predominantly recovered children (59.5%) in comparison to the second (43.5%, p <0.05) and the
third groups (25.0%, p <0.01). Further, the second group comprised more children with severe BPD (11.5%) in comparison
to the first group (0%, p <0.05). Overall, the presence of hemodynamically insignificant PDA contributed to the more severe
course of BPD at the treatment stage in the perinatal center and of 3-years-old children, in whom ductus arteriosus was closed
independently in the early neonatal period or was treated with a surgery.
mavropulotk@ukr.netT.K. Mavropulo, J Pediatr Care, Volume 4
DOI: 10.21767/2471-805X-C2-009