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Impact of a patent ductus arteriosus on non-invasive pre- and post-ductal blood pressures in extremely preterm infants during the first two postnatal weeks

Journal of Perinatology volume 45, pages 326–333 (2025)Cite this article

Subjects

Abstract

Objective

To evaluate pre- and post-ductal blood pressure (BP) in preterm infants according to patent ductus arteriosus (PDA) status obtained from targeted neonatal echocardiography (TnECHO).

Study design

Retrospective cohort study of infants born at 22–28 weeks divided according to three groups: (i) No PDA, (ii) Low volume shunt, (iii) Moderate-high volume shunt. BP parameters, demographics, and clinical characteristics were compared.

Result

A total of 373 TnECHOs were included: 98 no PDA, 152 low volume shunt, and 123 moderate-high volume shunt. TnECHOs with no PDA had higher systolic, diastolic, and mean BP. Diastolic flow reversal in the post-ductal descending aorta was associated with lower post-ductal diastolic (p < 0.001) and mean BP (p < 0.001). Moderate-high volume shunt had higher rates of diastolic hypotension.

Conclusion

BP patterns varied according to PDA status. Post-ductal hypotension was more common with a moderate-high volume shunt. PDA status in this population may be the strongest influencer of BP variability.

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Fig. 1: Boxplots of systolic, diastolic, and mean Blood Pressure according to group allocation of patent ductus arteriosus.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Funding

The authors have no financial relationships relevant to this article to disclose. NIH and CTSA grant number UM1TR004403 for REDCap use.

Author information

Author notes

  1. These authors contributed equally: Adrianne R. Bischoff, Amy A. Hobson.

Authors and Affiliations

  1. University of Iowa, Department of Pediatrics, Division of Neonatology, Iowa City, IA, USA

    Adrianne R. Bischoff, Amy A. Hobson, Patrick J. McNamara & Danielle R. Rios

  2. University of Iowa, Department of Internal Medicine, Iowa City, IA, USA

    Patrick J. McNamara

Authors
  1. Adrianne R. Bischoff
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  2. Amy A. Hobson
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  3. Patrick J. McNamara
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  4. Danielle R. Rios
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Contributions

ARB designed the study, performed all echocardiography analyses, wrote the first draft of the manuscript. AAH helped develop the cohort, completed data collection, and wrote the manuscript. PJM provided clinical expertise and oversight, reviewed and revised the manuscript. DRR helped with study design, provided direct supervision throughout the project, and reviewed and revised the manuscript.

Corresponding author

Correspondence to Danielle R. Rios.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

All methods were performed in accordance with relevant guidelines and regulations. This study was approved by the institutional review board at the University of Iowa (HawkIRB # 201410743). This study received a waiver of consent for participation of all subjects.

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Bischoff, A.R., Hobson, A.A., McNamara, P.J. et al. Impact of a patent ductus arteriosus on non-invasive pre- and post-ductal blood pressures in extremely preterm infants during the first two postnatal weeks. J Perinatol 45, 326–333 (2025). https://doi.org/10.1038/s41372-025-02223-2

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  • DOI: https://doi.org/10.1038/s41372-025-02223-2

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