Platelets and platelet derived growth factor and ductus arteriosus in preterm neonates

Background: Platelets and platelet derived growth factor (PDGF) play an important role in persistence and closure of ductus arteriosus (DA) in preterm neonates. Aim: To study the effect of Platelets count and PDGF on DA patency in preterm neonates. Methods: In a prospective study, performed in the neonatal intensive care unit (NICU) of Fayoum University Hospital, 75 preterm neonates with gestational age >33 weeks were assessed by Doppler echocardiography after 72 h of birth and classified into two groups (group 1: patent ductus arteriosus (PDA) group which included 40 preterm neonates and group 2: non-PDA group which included 35 preterm neonates). For all of them, complete blood count (CBC), C reactive protein (CRP) and serum PDGF were assessed. Results: Twenty six preterm neonates of group1 had hemodynamically significant PDA and received medical treatment in the form of an oral course of ibuprofen. Platelets count was significantly lower among PDA group, platelet distribution width (PDW) was significantly higher among PDA group, and platelets mass index (PMI) was significantly lower among PDA group. PDGF was significantly lower among PDA group on day 2 in comparison to non-PDA group and increased significantly from day 2 to day 5 in cases of PDA with spontaneous closure. Conclusions: Low platelets count and PMI and high PDW are associated with persistence of PDA and poor response to medical treatment, while up trending of PDGF level is associated with spontaneous PDA closure and good response to medical treatment in preterm neonates.