Division of Newborn Medicine, Department of Pediatrics, University of Massachusetts Medical School - Baystate, Springfield, MA, 01199, USA.
Epidemiology and Biostatistics Research Core, Office of Research, Baystate Medical Center, University of Massachusetts Medical School - Baystate, Springfield, MA, 01199, USA.
J Perinatol. 2021 May;41(5):998-1006. doi: 10.1038/s41372-020-00803-y. Epub 2020 Sep 2.
Evaluate predictors of successful PDA closure following acetaminophen treatment.
Retrospective cohort study of ≤30 weeks GA infants born from 1 January 2013-30 September 2019, and treated with single course acetaminophen by symptomatic PDA treatment strategy. Multiple maternal and neonatal variables were identified as potential predictors. Univariate analysis and multivariable regression models were applied to evaluate the strongest predictors.
Sixty-six patients were included, 28 (42.4%) had successful PDA closure following acetaminophen. Success was associated with GA > 26 weeks (65% vs. 33%, AUC = 0.64), birthweight >750 g (53% vs. 32%, AUC = 0.61), PDA size ≤0.2 cm (63% vs. 32%, AUC = 0.64), and no prior indomethacin use (56% vs. 33%, AUC = 0.61). Multivariable model identified GA > 26 weeks (RR = 1.92, CI 1.20-3.09) and PDA size ≤0.2 cm (RR: 1.82, CI 1.11-2.98) as the strongest predictors.
Acetaminophen may be more successful in targeted PDA closure in >26 weeks GA infants with PDA size ≤0.2 cm.
评估乙酰氨基酚治疗后动脉导管未闭（PDA）成功关闭的预测因素。
这是一项回顾性队列研究，纳入了 2013 年 1 月 1 日至 2019 年 9 月 30 日期间出生且胎龄（GA）≤30 周、并采用症状性 PDA 治疗策略接受单疗程乙酰氨基酚治疗的婴儿。确定了多个母体和新生儿变量作为潜在的预测因素。应用单变量分析和多变量回归模型来评估最强的预测因素。
共纳入 66 例患者，其中 28 例（42.4%）在接受乙酰氨基酚治疗后 PDA 成功关闭。成功与 GA>26 周（65%比 33%，AUC=0.64）、出生体重>750g（53%比 32%，AUC=0.61）、PDA 直径≤0.2cm（63%比 32%，AUC=0.64）和无先前使用吲哚美辛（56%比 33%，AUC=0.61）有关。多变量模型确定 GA>26 周（RR=1.92，CI 1.20-3.09）和 PDA 直径≤0.2cm（RR：1.82，CI 1.11-2.98）是最强的预测因素。
在 PDA 直径≤0.2cm 的>26 周 GA 婴儿中，乙酰氨基酚可能更有助于有针对性地关闭 PDA。
