WIP 54 - Exposure to Hemodynamically Significant Patent Ductus Arteriosus and Feeding Outcomes in Very Preterm Infants. A Retrospective Cohort Study

Publication Number: WIP 54.7510

Ana Nevarez Gilbert, University of Iowa, Iowa City, IA, United States; Samuel Wong, University of Iowa, Iowa city, IA, United States; Adrianne R. Bischoff, University of Iowa Stead Family Children's Hospital, Iowa City, IA, United States; Tarah Colaizy, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA, United States; Aamer Imdad, University of Iowa Stead Family Children's Hospital, Iowa City, IA, United States

Background: One in ten children born in the United States is premature. Preterm birth is associated with increased risk of medically complex conditions requiring highly specialized level of care and prolonged hospitalization. The prevalence of oral feeding difficulties is higher in this population, accounting for 21-37% of infants who remain admitted at 36 weeks post-menstrual age. A patent ductus arteriosus has been described as a risk factor for significant delay of introduction and advancement of enteral feeding and therefore associated with prolonged hospital stay

Objective: Identify the association of duration of exposure to a hemodynamically significant PDA (hsPDA) with achievement of full oral feeds at 36 weeks post menstrual age and length of hospital stay

Design/Methods: Retrospective observational cohort analysis on data from of the University of Iowa NICU of infants born at less than 29 6/7 weeks of gestation from January 1st 2019 to June 30th 2024. We will develop a multivariable logistic regression to assess the association of duration of exposure to hsPDA (defined based on IOWA PDA score ≥ 6, D.R. Rios, et al J Am Soc Echocardiogr, 34 (4) (2021), pp. 423-432) and achievement of full oral feeds at 36 weeks PMA (defined as 120 ml/kg/day) and length of hospital stay. Other variables to be included are day of life at initiation of enteral/oral feeds, day of life at full enteral/oral feeds, time in days to achieve full enteral/oral feeds and need for supplemental tube feeding at 36 weeks PMA or discharge. The study has been approved by the University of Iowa IRB and after reviewing preliminary data, we have identified 458 infants that meet inclusion criteria. 55% received therapy for a hsPDA. The mean length of hospital stay was 101 days and feeing milestones were collected on 92% of cohort. Our team is currently collecting further data on time of exposure to PDA. Our working hypothesis is that longer exposure to hsPDA is associated with later achievement of full enteral feeds and therefore longer length of hospital stay in infants born at less than 30 weeks of gestation