ArticleFrontiers in cardiovascular medicine2025
Risk factors for hemodynamically significant patent ductus arteriosus and ibuprofen treatment failure in premature twins: a retrospective case-control study.
Article in Frontiers in cardiovascular medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Premature twins face a dual challenge: a high incidence of hemodynamically significant patent ductus arteriosus (hsPDA) and a poor response to ibuprofen. Current management, derived from singleton data, fails to address this population's unique risks. Our study specifically investigates risk factors for hsPDA development and ibuprofen treatment failure in preterm twins to enable personalized prevention and therapy. Thus, the potential biomarkers for the occurrence of hsPDA and ibuprofen closure failure were examined. Methods: A single-center, retrospective case-control study. 736 twin infants born at ≤34 weeks of gestation were included, of which 70 were exposed to hsPDA and 66 were exposed to ibuprofen. Clinical data were obtained from the Electronic Medical Record system. For the occurrence of hsPDA and failure of ibuprofen treatment, multivariate logistic regression was employed to identify the independent risk factor and the potential biomarkers were examined. Results: 1. When compared to the non-hsPDA group, the hsPDA group demonstrated markedly higher incidences of low birth weight, lower gestational age, male gender, low 5 min Apgar scores, selective intrauterine growth restriction (sIUGR), use of pulmonary surfactant, respiratory distress syndrome (RDS), ≥grade III intraventricular hemorrhage, and early-onset sepsis ( Conclusions: In preterm twins ≤34 weeks, sIUGR is an IRF for hsPDA. In addition, MCDA and PROMs > 18 h are IRFs for ibuprofen treatment failure. Meanwhile, elevated levels of NT-proBNP and Hs-cTn may play a role in the development of hsPDA in preterm infants with sIUGR.
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