Exploring the relation between patent ductus arteriosus and bronchopulmonary dysplasia: Insights from national inpatient sample

Kirellos Said Abbas; Abdulrahman Al-Matary; Rawan Elabd; Michele Fouad; Nouran Badreldin; Muhannad Sharara; Moustafa Elsebey; Monica Dobs; Adnan I Qureshi; Abdul Rahman Adi; Afrah Ghawi; Ghadeer Ghazi Alahmadi; Huda Yahya Alyahyawi; Ahlam Mazi; Reem Abdullah Alyoubi

doi:10.4103/apc.apc_118_24

Exploring the relation between patent ductus arteriosus and bronchopulmonary dysplasia: Insights from national inpatient sample

Ann Pediatr Cardiol. 2024 Jul-Aug;17(4):250-256. doi: 10.4103/apc.apc_118_24. Epub 2024 Nov 15.

Authors

Kirellos Said Abbas¹, Abdulrahman Al-Matary², Rawan Elabd¹, Michele Fouad¹, Nouran Badreldin³, Muhannad Sharara⁴, Moustafa Elsebey⁵, Monica Dobs⁶, Adnan I Qureshi^{7

8}, Abdul Rahman Adi⁹, Afrah Ghawi¹⁰, Ghadeer Ghazi Alahmadi¹¹, Huda Yahya Alyahyawi¹², Ahlam Mazi¹¹, Reem Abdullah Alyoubi¹¹

Affiliations

¹ Faculty of Medicine, Alexandria University, Alexandria, Egypt.
² Department of Neonatology, King Fahad Medical City, Riyadh, Saudi Arabia.
³ Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
⁴ Georgia Cancer Center, Augusta University, Augusta, Georgia, USA.
⁵ Department of Pediatrics, University of Florida, Pensacola, Florida, USA.
⁶ University of Florida College of Medicine, Jacksonville, Florida, USA.
⁷ Zeenat Qureshi Stroke Institute, University of Minnesota, St Cloud, Minnesota, USA.
⁸ Department of Neurology, University of Missouri, Columbia, Missouri, USA.
⁹ College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
¹⁰ Department of Pediatrics, King Fahad Central Hospital, Jazan, Saudi Arabia.
¹¹ Department of Pediatrics, King Abdulaziz University, Jeddah, Saudi Arabia.
¹² Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.

Abstract

Background: Bronchopulmonary dysplasia (BPD) poses a challenge in neonatal care. Previous literature recommended a hypothetical role for patent ductus arteriosus (PDA) in the development of BPD. This study explores the possible link between PDA and BPD, aiming to illuminate demographic and clinical factors influencing BPD development within the context of PDA.

Methods: This retrospective cohort analysis employed data from the National Inpatient Sample (NIS) spanning from 2016 to 2020. The study focused on patients diagnosed with PDA and BPD, identified through International Classification of Diseases 10^th Revision codes Q250 and P271, respectively. Utilizing STATA ×15, descriptive and inferential statistics, encompassing univariate and multivariate regression analyses, were conducted to examine the association between PDA and BPD.

Results: A total of 9737 patients were included: 5133 without PDA and 4604 with PDA. The mortality rate was significantly higher among patients with PDA (3.80%) compared to those without PDA (2.53%) (P < 0.0001). Univariate and multivariate regression analyses identified a significant association between PDA and BPD, with odds ratios of 14.62 and 2.43, respectively (both P < 0.0001). BPD patients with PDA also exhibited a significantly higher prevalence of extremely preterm birth (76.24% vs. 58.31%, P < 0.0001) and extremely low birth weight (65.57% vs. 42.70%, P < 0.0001) compared to BPD patients without PDA. In addition, significant associations were observed between BPD and factors such as preterm birth category, neonatal sepsis, race, hospital status, and region (all P < 0.0001).

Conclusions: This research confirms the connection between PDA and BPD, stressing the importance of continued investigation and prospective studies. The findings highlight the need to consider several factors in understanding the etiology of the disease, which could lead to more targeted interventions and improved patient care.

Keywords: National inpatient sample dataset; retrospective cohort analysis; risk factors and prevalence of bronchopulmonary dysplasia.