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Original Article

Perinatal risk factors for hemodynamically significant patent ductus arteriosus in very low birth weight infants

Jie Hee Jue¹  , So Young Shin²  , Jae Hyun Park²  , Chun Soo Kim³  , Hee Joung Choi³ 

¹Division of Pediatric Emergency Medicine, Kyungpook National University Children’s Hospital, Daegu, Korea
²Department of Pediatrics, Keimyung University Dongsan Hospital, Daegu, Korea
³Department of Pediatrics, Keimyung University School of Medicine, Daegu, Korea

Correspondence Hee Joung Choi ,Email: joung756@dsmc.or.kr

Received: August 16, 2025; Revised: October 23, 2025   Accepted: November 10, 2025.

Abstract

Background
Multiple perinatal factors influence hemodynamically significant patent ductus arteriosus (HS PDA) in preterm infants.
Purpose
This study aimed to identify the risk factors associated with HS PDA in very low birth weight infants (VLBWIs) and determine the predictors of surgical ligation.
Methods
This retrospective study included VLBWIs born at 23–32 weeks’ gestation whose HS PDA properties could be identified using echocardiography. The infants were stratified into 2 groups based on gestational age (23– 27 and 28–32 weeks).
Results
Among the 496 included VLBWIs, 171 had no PDA, 90 had non-HS PDA, and 235 had HS PDA. In infants born at 23–27 weeks’ gestation, risk factors for HS PDA included low birth weight, the absence of histological chorioamnionitis, and premature rupture of membranes. For VLBWIs born at 28–32 weeks’ gestation, HS PDA was associated with lower birth weight, frequent surfactant treatment, and maternal hypertension. Within the HS PDA group, infants with a lower birth weight or who received incomplete antenatal steroid administration had an increased likelihood of requiring surgical ligation, whereas those with a small-for-gestational-age status had a decreased need for surgical ligation.
Conclusion
Recognizing these risk factors can aid the development of targeted treatment strategies for HS PDA in VLBWIs, enabling early ligation and potentially reducing the need for surgical management.

Keywords :Patent ductus arteriosus, Premature Infant, Very low birth weight infant, Risk factors