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Journal of the Korean Society of Neonatology 2010;17(1):75-83.
Published online May 1, 2010.
Predictors of Failed Closure of Patent Ductus Arteriosus with the First Course of Indomethacin in Preterm Infants.
Mong Young Lee, Dong Hee Lim, Kyu Hee Park, Jang Hoon Lee, Byung Min Choi, Kee Hwan Yoo, Young Sook Hong, Joo Won Lee
1Aideul Pediatric Clinic, Seoul, Korea.
2Department of Pediatrics, Korea University, School of Medicine, Seoul, Korea. yshong23@hanmail.net
미숙아 동맥관 개존에서 인도메타신 1차 투여 후 폐쇄 실패의 예측 인자
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This study was performed to determine the predictors of failed closure of a patent ductus arteriosus (PDA) following the first course of indomethacin in symptomatic preterm infants.
Forty three of 43 preterm infants, admitted to the neonatal intensive care unit diagnosed with PDA and treated with indomethacin at the Korea University Medical Center between January 1990 and October 2007, ware studied. The perinatal risk factors affecting the failed closure of PDA were retrospectively assessed.
The failed PDA closure group included 16 (37%) out of 43 infants three of whom underwent surgery. The closure group included 27 (63%) out of 43 infants. In the failed closure group, the Apgar scores (1 min, 5 min) were significantly higher (P<0.05) and antenatal steroid administration was significantly lower (P<0.05). In addition, dopamine administration was significantly lower (P<0.05) and the mean postnatal age at diagnosis was significantly lower (P<0.05). Multiple logistic regression for the prediction of failed PDA closure found only antenatal steroid administration (OR 0.092, CI 0,010-0.826, P=0.0331) as an associated factor.
In patients with antenatal steroid administration the failed PDA closure rate was significantly lower. Therefore, antenatal steroid administration can be considered as an important factor for the closure of PDA in preterm pregnancies.
Key Words: Ductus Arteriosus, Patent, Indomethacin, Infant, Premature


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