Department of Pediatrics, Cathay General Hospital, Hsinchu Branch, Hsinchu, Taiwan.
Department of Pediatrics, Cathay General Hospital, Taipei, Taiwan.
Am J Perinatol. 2022 Oct;39(13):1426-1432. doi: 10.1055/s-0040-1722649. Epub 2021 Jan 24.
The incidence of patent ductus arteriosus (PDA), a major complication of prematurity, may be reduced by restricting fluid administration. Prophylactic fresh frozen plasma (FFP) transfusion may reduce the incidence of intraventricular hemorrhage in these infants, but risks transfusion-related volume overload. We conducted a retrospective study to investigate whether FFP transfusion is a risk factor for hemodynamically significant PDA (hsPDA) in very low birth weight (BW) premature infants.
From January 2009 to December 2014, 102 premature infants with gestational age (GA) less than or equal to 30 weeks were admitted to a level III neonatal intensive care unit, and 88 patients were enrolled. Patients were further divided into non-hsPDA ( = 29) and hsPDA groups ( = 59). We retrospectively reviewed demographic characteristics and various perinatal and postnatal variables. Univariate and multivariable analyses were performed to identify risk factors for hsPDA.
Compared with non-hsPDA patients, hsPDA patients had lower mean BW and GA, a higher incidence of severe respiratory distress symptoms, perinatal infection, use of surfactant, and need for FFP transfusion. However, multivariable logistic regression analysis showed that only FFP transfusion remained an independent risk factor for hsPDA (adjusted odds ratio = 3.880, 95% confidence interval: 1.214-12.402, = 0.022) after adjusting for confounding factors.
FFP transfusion is a significant risk factor for the subsequent development of hsPDA in our study population. FFP transfusion may complicate the fluid management of premature infants and increase the risk of hsPDA.
· Hemodynamic significant PDA is an important complication of preterm infant.. · FFP transfusion may complicate the fluid management of premature infants.. · FFP transfusion is an independent risk factor for hsPDA in very low birth weight premature infants..
动脉导管未闭（PDA）是早产儿的主要并发症之一，通过限制液体摄入可能会降低其发病率。预防性新鲜冷冻血浆（FFP）输注可能会降低这些婴儿颅内出血的发生率，但存在与输血相关的血容量过多的风险。我们进行了一项回顾性研究，以调查 FFP 输注是否是极低出生体重（BW）早产儿发生有临床意义的 PDA（hsPDA）的危险因素。
从 2009 年 1 月至 2014 年 12 月，102 名胎龄（GA）小于或等于 30 周的早产儿入住三级新生儿重症监护病房，其中 88 名患儿符合入组标准。患儿进一步分为非 hsPDA（ = 29）和 hsPDA 组（ = 59）。我们回顾性分析了人口统计学特征和各种围产期及产后变量。采用单变量和多变量分析来确定 hsPDA 的危险因素。
与非 hsPDA 患者相比，hsPDA 患者的平均 BW 和 GA 较低，严重呼吸窘迫症状、围产期感染、使用表面活性剂和需要 FFP 输注的发生率较高。然而，多变量逻辑回归分析显示，在校正混杂因素后，FFP 输注仍然是 hsPDA 的独立危险因素（调整后的优势比= 3.880，95%置信区间：1.214-12.402， = 0.022）。
在本研究人群中，FFP 输注是 hsPDA 后续发生的一个显著危险因素。FFP 输注可能会使早产儿的液体管理复杂化，并增加 hsPDA 的风险。
· 有临床意义的 PDA 是早产儿的重要并发症之一。· FFP 输注可能会使早产儿的液体管理复杂化。· FFP 输注是极低出生体重早产儿发生 hsPDA 的独立危险因素。
