Significant patent ductus arteriosus as independent risk factor for necrotizing enterocolitis in preterm infants

Objectives: Preterm newborns with patent ductus arteriosus (PDA) are at greater risk for bronchopulmonary dysplasia (BPD), decreased perfusion of vital organs and mortality. The aim of study was to determine relationship between the existence of PDA and the development of necrotizing enterocolitis (NEC) in preterm infants. Methods: The study included 51 preterm infants with necrotizing NEC, admitted to the neonatal intensive care unit (NICU) at the University Clinical Center Sarajevo. In patients with NEC, 30 patients were treated conservatively (NEC II group), while 21 patients were treated surgically (NEC III group). The control group consisted of 71 preterm infants without necrotizing enterocolitis. The PDA was diagnosed by the presence of bounding peripheral pulses, and confirmed by two-dimensional Doppler echocardiography. Results: A statistically significant difference in PDA frequency was observed between the NEC group of patients and control group (χ2=11.484; p=0.0007), between the NEC II and control group (χ2=11.033; p=0.0009) and between the NEC III group and control group (χ2=5.557; p=0.0184). Logistic regression analysis revealed that PDA is an independent risk factor for the development of NEC (OR=10.95; 95% CI: 2.10, 57.08). Conclusion: Our data suggest that PDA represents independent risk factor for the development of NEC in premature infants, probably due to the influence of PDA on compromising mesenteric perfusion. Keywords: patent ductus arteriosus, necrotizing enterocolitis, preterm infants