Clinical-Statistical Analysis of the Determinant Factors in the Evolution, Closure, and Mortality of Patent Ductus Arteriosus in Neonates

¹Neonatology Resident, University Catolica Santiago de Guayaquil, Hospital Roberto Gilbert Elizalde, Ecuador

²Neonatologist, Hospital Roberto Gilbert Elizalde, University Catolica Santiago de Guayaquil, Ecuador

*Corresponding author: Ana María Guadamud Intriago, Neonatology Resident, University Catolica Santiago de Guayaquil, Hospital Roberto Gilbert Elizalde, 90504, Ecudaor, Phone: 0958613779, E-mail: [email protected]

Received: May 26, 2026

Published: August 05, 2026

Citation: Maria GA, Sara MV. (2026). Clinical-Statistical Analysis of the Determinant Factors in the Evolution, Closure, and Mortality of Patent Ductus Arteriosus in Neonates. Neonatal. 7(2):33.

Copyright: Maria GA and Sara MV. © (2026).

ABSTRACT

Introduction: Patent Ductus Arteriosus (PDA) is one of the most prevalent cardiovascular abnormalities during the neonatal period, significantly affecting morbidity, mortality, and respiratory stability in preterm patients admitted to intensive care units.

Objectives: To determine the clinical-statistical and demographic factors correlated with ductal diameter evolution, the effectiveness of conservative versus pharmacological management, the need for surgical ligation, and mortality rate in a sample of 247 neonatal patients.

Methodology: A quantitative, correlational, descriptive, and cross-sectional study was conducted based on the clinical records of 247 neonates diagnosed with PDA. Baseline variables (sex and gestational age), ductal morphometry (echocardiographic diameter in millimeters and grading classification), therapeutic management (conservative management and duration of pharmacological treatment), closure success rate, and final outcome (mortality) were evaluated. Descriptive analysis included means, standard deviations, kurtosis, variances, and relative/cumulative frequency analyses.

Results: Among the 247 neonates analyzed, 126 (51.01%) were male and 121 (48.99%) were female. The mean gestational age of the cohort was 32.68 weeks (SD = 2.66), with a marked predominance of moderate to very preterm infants (28–33 weeks). The mean ductal diameter was 1.69 mm (SD = 0.66; range 1–4 mm), with most patients classified as Grade 1 (n = 133; 53.85%), followed by Grade 2 (n = 64; 25.91%) and Grade 3 (n = 50; 20.24%). Conservative treatment demonstrated a 100% closure success rate in the 186 cases in which it was indicated (75.30%). Pharmacological treatment was administered in 61 cases (24.70%), lasting 7 days in 73.77% and 5 days in 26.23% of these patients, achieving medical closure in 25 neonates. The remaining 36 patients (14.57% of the total cohort) experienced failure of medical closure and required surgical ligation, with 100% belonging to Grade 3 PDA. Overall mortality was 7.69% (19 neonates), strongly correlated with extreme prematurity and luminal diameters > 2 mm.

Conclusions: Initial ductal diameter and gestational age constitute the main predictive factors for failure of conservative/medical treatment and overall mortality. Sequential pharmacological management and selective surgical ligation are consolidated as effective strategies for advanced echocardiographic stages.

Keywords: Patent Ductus Arteriosus, Partial Oxygen Pressure, Necrotizing Enterocolitis, Intraventricular Hemorrhage, Newborns