Platelet count and associated morbidities in VLBW infants with pharmacologically treated patent ductus arteriosus

Abstract

Objective: Characterize the diagnosis of PDA and the distribution of pretreatment platelet count in pharmacologically managed PDA in infants ≤1500 g and assess the relationship of platelet count to serious morbidities.

Study design: This is a retrospective, observational study. In 40 hospitals, data were collected on PDA, including pretreatment platelet count. Distribution of platelet count was examined. The association of platelet count and clinical outcomes of IVH, NEC and PDA closure prior to discharge were examined. Chi-square test was used to compare outcomes by platelet count groups.

Results: There were 311 patients treated with medically treated PDA. Pretreatment platelet counts were categorized as 0–119 K, 120–199 K, 200–299 K, >300 K. Incidence and grade of IVH were not significantly different by platelet group. Across all groups: No IVH 62–83%, Grades 1–2 IVH 13–25%, Grades 3–4 IVH 2–13%. NEC occurred in 0–11% of all patients studied. PDA closure rate was 33–45%.

Conclusion: PDA closure was not significantly affected by platelet count. Platelet count was not a statistically significant factor for development of IVH and NEC in infants born <1500 g with pharmacologically treated PDA.

• COX1 inhibitor
• intraventricular hemorrhage
• ligation
• necrotizing enterocolitis
• patent ductus arteriosus
• thrombocytopenia
• very low birth weight

Acknowledgements

The authors thank the CPQCC Perinatal Quality Improvement Panel for guidance on study design and execution, and Maxmillian Egan for editorial assistance. We acknowledge the contributions of the clinicians and staff at the following hospital NICUs that participated in the CPQCC PQIP PDA supplemental data collection: Mercy San Juan Medical Center, Cedars-Sinai Medical Center, Kaiser Los Angeles, Kaiser Fontana, Kaiser San Diego, Children’s Hospital of Orange County, Northbay Medical Center, Miller Children’s Hospital at Long Beach Memorial Hospital, Providence Tarzana Medical Center, University of California San Diego Medical Center, Rady Children’s Hospital San Diego, University of California Irvine Medical Center, Good Samaritan Hospital San Jose, San Francisco General Hospital, Harbor UCLA Medical Center, Kaiser Orange County – Anaheim, Kaiser West Los Angeles, Alta Bates Summit Medical Center, Presbyterian Intercommunity Hospital, Ventura County Medical Center, Children’s Hospital Central California, Kaiser Baldwin Park, Kaiser Riverside, Kaiser Panorama City, Citrus Valley Medical Center, Children’s Hospital Los Angeles, Children’s Hospital of Orange County at Mission, Palomar Medical Center, Anaheim Regional Medical Center, Bakersfield Memorial Hospital, Natividad Medical Center, Torrance Memorial Medical Center, Rady Children’s Hospital San Diego at Scripps La Jolla, Community Regional Medical Center, O’Connor Hospital, Santa Rosa Memorial Hospital, Tri-City Medical Center, Saddleback Memorial Hospital, Mercy Southwest Hospital, Kaiser Downey.

Declaration of interest

The project described was supported by Grant Number K23HD068400 from the Eunice Kennedy Shriver National Institute of Child Health & Human Development. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Eunice Kennedy Shriver National Institute of Child Health & Human Development or the National Institutes of Health. The funder did not have any role in any of the following: design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.