Impact of a patent ductus arteriosus on non-invasive pre- and post-ductal blood pressures in extremely preterm infants during the first two postnatal weeks

Abstract

Objective: To evaluate pre- and post-ductal blood pressure (BP) in preterm infants according to patent ductus arteriosus (PDA) status obtained from targeted neonatal echocardiography (TnECHO). Study design: Retrospective cohort study of infants born at 22–28 weeks divided according to three groups: (i) No PDA, (ii) Low volume shunt, (iii) Moderate-high volume shunt. BP parameters, demographics, and clinical characteristics were compared. Result: A total of 373 TnECHOs were included: 98 no PDA, 152 low volume shunt, and 123 moderate-high volume shunt. TnECHOs with no PDA had higher systolic, diastolic, and mean BP. Diastolic flow reversal in the post-ductal descending aorta was associated with lower post-ductal diastolic (p < 0.001) and mean BP (p < 0.001). Moderate-high volume shunt had higher rates of diastolic hypotension. Conclusion: BP patterns varied according to PDA status. Post-ductal hypotension was more common with a moderate-high volume shunt. PDA status in this population may be the strongest influencer of BP variability.