{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T06:00:00Z","timestamp":1781244000862,"version":"3.54.1"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Intraventricular hemorrhage (IVH) remains a major complication in extremely preterm infants, but the immediate hemodynamic changes associated with hemorrhage after ductal closure are not well defined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a two-center retrospective cohort study conducted at two tertiary neonatal intensive care units. Hemodynamic parameters, including left ventricular diastolic diameter, mean velocity of circumferential fiber shortening, end-systolic wall stress, mean arterial pressure, heart rate, and internal cerebral vein waveform grade, were assessed serially from birth to 72\u2005h of life. Generalized linear mixed-effects models were used to evaluate temporal associations between post-closure hemodynamic changes and IVH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In this two-center retrospective cohort study, 26 infants born at 22\u201323 weeks\u2019 gestation were included. Seven infants developed grade 2\u20134 IVH, all first detected after PDA closure, while 19 who did not IVH. Infants who developed IVH showed a distinct post-closure pattern characterized by increased end-systolic wall stress, mean arterial pressure, and heart rate, together with reduced mean velocity of circumferential fiber shortening, within 12\u2005h after ductal closure. Between-group differences were significant at 6 and 12\u2005h after closure (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Hemodynamic instability emerging within 12\u2005h after ductal closure was associated with subsequent IVH in infants born at 22\u201323 weeks\u2019 gestation. These findings identify the immediate post-closure period as a critical window for circulatory monitoring and potential targeted intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1825698","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T05:47:25Z","timestamp":1781243245000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Hemodynamic evaluation following ductal closure and association with IVH in premature infants born at 22\u201323weeks gestation"],"prefix":"10.3389","volume":"14","author":[{"given":"Tomonori","family":"Kurimoto","sequence":"first","affiliation":[{"name":"Department of Neonatology, Perinatal Medical Center, Kagoshima City Hospital","place":["Kagoshima, Japan"]},{"name":"Department of Neonatology, Kanagawa Children\u2019s Medical Center","place":["Yokohama, 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