Objective: To probe into the closure rate of symptomatic patent ductus arteriosus (sPDA) and non-symptomatic patent ductus arteriosus (nsPDA) after drug intervention and analyze the incidence of related complications

so as to further guide the clinical application. Methods: Retrospective analysis was performed on 252 cases of preterm infants with gestational age <34 weeks and diagnosed as patent ductus arteriosus (PDA) by echocardiography at the first weekend after birth from the neonatology department of Tongji Hospital from May 2016 to Apr. 2019. According to the sPDA diagnostic criteria

all patients were divided into 94 cases in the sPDA group and 158 cases in the nsPDA group. The nsPDA group was divided into 92 cases in the nsPDA-1 group and 66 cases in the nsPDA-2 group. All children in the sPDA group and the nsPDA-1 group received oral ibuprofen during the hospitalization. Children in the nsPDA-2 group were not treated with ibuprofen during the hospitalization. Echocardiography was reviewed on all preterm infants after treatment or before discharge. Clinical data of three groups were collected to analyze the closure rate of PDA and the incidence of related complications related to PDA. Results: The gestational age and birth weight of children in the sPDA group were lower than those in the nsPDA-1 group and the nsPDA-2 group (P<0.05)

yet there was no significant difference in gestational age and birth weight between the nsPDA-1 group and the nsPDA-2 group (P>0.05). After oral ibuprofen treatment

ductus arteriosus was closed in 52 cases in the sPDA group and 81 cases in the nsPDA-1 group

and the closure rate was 55.3% and 88.0%. In the nsPDA-2 group

54 cases of preterm infants had natural ductus arteriosus closure

with the closure rate of 81.8%. The ductus arteriosus closure rate in the sPDA group was lower than that in the nsPDA-1 group and the nsPDA-2 group (P<0.05)

yet there was no significant difference in the closure rate of ductus arteriosus between the nsPDA-1 group and the nsPDA-2 group (P>0.05). The incidence of pneumonia

bronchopulmonary dysplasia (BPD)

feeding intolerance

necrotizing enterocolitis (NEC) and intracranial hemorrhage (IVH) in the sPDA group was higher than that in the nsPDA-1 group and the nsPDA-2 group (P<0.05)

yet there was no statistically significant difference in the incidence of above complications between the nsPDA-1 group and the nsPDA-2 group (P>0.05). There was no significant difference in the incidence of renal injury between the sPDA group and the nsPDA-1 group (P>0.05)

but both were higher than those in the nsPDA-2 group (P<0.05). Conclusion: The incidence of sPDA is higher in preterm infants with younger gestational age and lower birth weight. Premature infants with sPDA have poor efficacy in oral ibuprofen treatment

and are more likely to have related complications (pneumonia

BPD

feeding intolerance

NEC and IVH).