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Pediatr."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Patent ductus arteriosus (PDA) treatment remains controversial. Modeling on the predictive capacity of early spontaneous PDA closure would help in decision-making.<\/jats:p><jats:p><jats:bold>Aim:<\/jats:bold> To design a predictive model of early spontaneous PDA closure.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> As part of a trial to assess efficacy and safety of two ibuprofen treatment schemes for PDA, infants below 29 weeks' gestation were scanned between 18 and 72 h of birth, and serially if indicated. PDA treatment was decided based on echocardiography signs of lung overflow or systemic hypoperfusion and clinical criteria. A PDA score that included the echocardiographic parameters significantly associated with treatment prescription was retrospectively applied. Perinatal variables and screening score were included in a backwards elimination model to predict early spontaneous closure.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Among 87 eligible infants (27 weeks' gestation; age at screening 45 h), 21 received ibuprofen at 69 h of life [screening score = 7 (IQR = 5\u20138.5); score at treatment = 9 (IQR = 8\u20139)], while 42 infants had conservative management, [screening score = 1 (IQR = 0\u20134)]. Twenty four infants were excluded (ibuprofen contraindication, declined consent or incomplete echocardiography). Screening score showed an AUC = 0.93 to predict early spontaneous PDA closure, [cut-off value = 4.5 (sensitivity = 0.90, specificity = 0.86)]. The predictive model for early spontaneous PDA closure followed the equation: Log (p\/1-p) = \u221228.41 + 1.23<jats:sup>*<\/jats:sup> gestational age \u22120.87<jats:sup>*<\/jats:sup> PDA screening score.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> A predictive model of early spontaneous PDA closure that includes gestational age and the screening PDA score is proposed to help clinicians in the decision- making for PDA treatment. In addition, this model could be used in future intervention trials aimed to prevent PDA related morbidities to improve the eligibility criteria.<\/jats:p>","DOI":"10.3389\/fped.2021.644519","type":"journal-article","created":{"date-parts":[[2021,2,26]],"date-time":"2021-02-26T05:43:56Z","timestamp":1614318236000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Predictive Model of Early Spontaneous Ductus Arteriosus Closure Based on Neonatologist Performed Echocardiography in Preterm Infants"],"prefix":"10.3389","volume":"9","author":[{"given":"Mar\u00eda Carmen","family":"Bravo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebeca","family":"S\u00e1nchez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Isabel","family":"Blanco","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Itsaso","family":"Losantos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adelina","family":"Pellicer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,2,26]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1149","DOI":"10.1016\/j.jpeds.2015.06.032","article-title":"Natural history of patent ductus arteriosus in very low birth weight infants after discharge","volume":"167","author":"Weber","year":"2015","journal-title":"J Pediatr"},{"key":"B2","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1542\/peds.112.1.33","article-title":"Hemodynamic and antecedent risk factors of early and late periventricular\/intraventricular hemorrhage in premature infants","volume":"112","author":"Osborn","year":"2003","journal-title":"Pediatrics"},{"key":"B3","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1053\/j.semperi.2013.01.006","volume":"37","year":"2013","journal-title":"Semin Perinatol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"e138","DOI":"10.1542\/peds.2008-2418","article-title":"Failure of ductus arteriosus closure is associated with increased mortality in preterm infants","volume":"123","author":"Noori","year":"2009","journal-title":"Pediatrics"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1488","DOI":"10.1016\/j.jpeds.2015.03.012","article-title":"Association between hemodynamically significant patent ductus arteriosus and bronchopulmonary dysplasia","volume":"16","author":"Schena","year":"2015","journal-title":"J Pediatr"},{"key":"B6","doi-asserted-by":"publisher","first-page":"2576","DOI":"10.1080\/14767058.2017.1347921","article-title":"Morbidities associated with patent ductus arteriosus in preterm infants. 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