Journal of Developmental Medicine(Electronic Version)  2025, Vol. 13 Issue (3): 175-181 DOI: 10.3969/j.issn.2095-5340.2025.03.003 |
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| Impact of patent ductus arteriosus on later cerebral perfusion in extremely preterm infants based on arterial spin labeling technique |
| Kong Xiangbo, Song Hao, Qin Fanyue, et al
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Department of Neonatology, the Third Affiliated Hospital of Zhengzhou University, Henan, Zhengzhou 450052, China
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Abstract 【Abstract】 Objective To apply arterial spin labeling (ASL) imaging to assess cerebral perfusion in
extremely preterm infants and investigate the impact of patent ductus arteriosus (PDA) on cerebral perfusionin extremely preterm infants corrected to near-term gestational age. Method A retrospective studywas conducted, including 150 extremely preterm infants with a gestational age of less than 32 weeks andmore than 28 weeks who were delivered at the Department of Obstetrics, the Third Affiliated Hospital ofZhengzhou University from June 2021 to June 2023, and subsequently hospitalized in the Department of
Neonatology. These infants underwent cranial magnetic resonance imaging and ASL examinations at a
corrected gestational age of 35 to 37 weeks. Based on the echocardiographic results during hospitalization
and the diagnostic criteria for hemodynamically significant PDA (hsPDA), the infants were divided into threegroups: the non-PDA (nPDA) group (n=40), the non-hemodynamically significant PDA (nhsPDA)group (n=75),and the hsPDA group (n=35). Compare the maternal conditions during pregnancy, treatments and complicationsduring hospitalization, and cerebral perfusion status at near-term corrected gestational age among three groups ofextremely preterm infants. Statistical methods performed by ANOVA, Kruskal-Wallis test, χ2 test or Fisher exactprobability method, Bonferroni test, and multiple linear regression analysis. Result The 1-minute Apgar scoresfor the nPDA group, nhsPDA group, and hsPDA group were 8.00 (8.00, 9.00), 8.00 (8.00, 9.00), and 8.00 (5.50,8.50), respectively. The 5-minute Apgar scores were 9.00 (9.00, 9.00), 9.00 (8.00, 9.50), and 9.00 (7.00, 9.00),respectively. The 1-minute and 5-minute Apgar scores in the hsPDA group were significantly lower thanthose in the nPDA group and nhsPDA group (H values for 1-minute Apgar scores were 26.186 and 25.606,respectively, and H values for 5-minute Apgar scores were 28.904 and 25.072, respectively, all P<0.05). Theincidence of white matter injury (WMI) in the hsPDA group was higher than that in the nPDA group and thenhsPDA group [25.71% (9/35) vs 7.5% (3/40) and 9.33% (7/75), χ2 values were 4.608 and 5.152, respectively,all P<0.05). There was no statistically significant difference in cerebral perfusion among the three groupsof extremely preterm infants when corrected to near-term gestational age (P>0.05). The multivariate linearregression analysis which included factors such as intraventricular hemorrhage and WMI, revealed thathsPDA had no significant impact on cerebral perfusion in extremely preterm infants when corrected to neartermgestational age (P>0.05). Conclusion hsPDA is associated with lower Apgar score and the occurrenceof WMI. However, after ductal closure through medication or surgery, hsPDA has no impact on later cerebral perfusion in extremely preterm infants.
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Received: 02 December 2024
Published: 31 May 2025
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