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Am J Perinatol 2019; 36(14): 1521-1527
DOI: 10.1055/s-0039-1688821
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Useful Platelet Indices for the Diagnosis and Follow-Up of Patent Ductus Arteriosus

Elif Guler Kazanci
1   Department of Pediatric Hematology, Bursa High Specialist Training and Research Hospital, University of Health Sciences, Bursa, Turkey
,
Mehmet Buyuktiryaki 
2   Division of Neonatology, Zekai Tahir Burak Maternity Education and Research Hospital, University of Health Sciences, Ankara, Turkey
,
Handan Unsal
3   Department of Pediatric Cardiology, Zekai Tahir Burak Maternity Education and Research Hospital, University of Health Sciences, Ankara, Turkey
,
Cuneyt Tayman
2   Division of Neonatology, Zekai Tahir Burak Maternity Education and Research Hospital, University of Health Sciences, Ankara, Turkey
› Author Affiliations Funding None.
Further Information

Publication History

12 March 2019

01 April 2019

Publication Date:
14 May 2019 (online)

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Abstract

Objective The aim of this study was to assess the utility of early postnatal platelet indices in the prediction of hemodynamically significant patent ductus arteriosus (hsPDA) and its response to pharmacological treatment in preterm infants.

Study Design The medical records of 971 infants with gestational age < 30 weeks and birth weight < 1,500 g were analyzed retrospectively. Infants with hsPDA comprised the study group and those without hsPDA comprised the control group. Complete blood count results were recorded, and red cell distribution width-to-platelet ratio (RPR) and platelet mass were calculated.

Results A total of 481 infants, 169 in the hsPDA group and 312 in the control group, were included. In terms of platelet indices, the hsPDA group showed significantly lower mean platelet volume (MPV) and platelet mass, whereas RPR was significantly higher (p < 0.05, respectively). Multiple logistic regression analysis showed that RDS (relative ratio [RR]: 2.39; 95% confidence interval [CI]: 1.45–3.93; p < 0.001), MPV < 7.85 (RR: 3.71; 95% CI: 2.29–6.01; p < 0.001), and RPR > 0.070 (RR: 5.33; 95% CI: 3.28–8.65; p < 0.001) were independent risk factors for hsPDA.

Conclusion Low MPV and platelet mass and high RPR in the first hours of life are risk factors for hsPDA and hsPDA refractive to pharmacological treatment with ibuprofen in preterm infants.

Keywords

mean platelet volume - patent ductus arteriosus - platelet mass - red cell distribution width to platelet ratio

Authors' contributions

E.G.K., M.B., H.U., and C.T. designed the research. M.B., H.U., and C.T. conducted the research and followed up with patients. E.G.K., M.B., and C.T. made statistical analyses. E.G.K., M.B., H.U., and C.T. wrote the paper with revision. E.G.K. and M.B. had primary responsibility for final content.


 

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