Useful Platelet Indices for the Diagnosis and Follow-Up of Patent Ductus Arteriosus

Am J Perinatol. 2019 Dec;36(14):1521-1527. doi: 10.1055/s-0039-1688821. Epub 2019 May 14.


Objective: The aim of this study was to assess the utility of early postnatal platelet indices in the prediction of hemodynamically significant patent ductus arteriosus (hsPDA) and its response to pharmacological treatment in preterm infants.

Study design: The medical records of 971 infants with gestational age < 30 weeks and birth weight < 1,500 g were analyzed retrospectively. Infants with hsPDA comprised the study group and those without hsPDA comprised the control group. Complete blood count results were recorded, and red cell distribution width-to-platelet ratio (RPR) and platelet mass were calculated.

Results: A total of 481 infants, 169 in the hsPDA group and 312 in the control group, were included. In terms of platelet indices, the hsPDA group showed significantly lower mean platelet volume (MPV) and platelet mass, whereas RPR was significantly higher (p < 0.05, respectively). Multiple logistic regression analysis showed that RDS (relative ratio [RR]: 2.39; 95% confidence interval [CI]: 1.45-3.93; p < 0.001), MPV < 7.85 (RR: 3.71; 95% CI: 2.29-6.01; p < 0.001), and RPR > 0.070 (RR: 5.33; 95% CI: 3.28-8.65; p < 0.001) were independent risk factors for hsPDA.

Conclusion: Low MPV and platelet mass and high RPR in the first hours of life are risk factors for hsPDA and hsPDA refractive to pharmacological treatment with ibuprofen in preterm infants.

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Blood Cell Count
  • Case-Control Studies
  • Drug Resistance
  • Ductus Arteriosus, Patent / blood
  • Ductus Arteriosus, Patent / diagnosis*
  • Ductus Arteriosus, Patent / drug therapy
  • Erythrocyte Indices*
  • Female
  • Follow-Up Studies
  • Gestational Age
  • Humans
  • Ibuprofen / therapeutic use
  • Infant, Newborn
  • Infant, Premature / blood*
  • Infant, Premature, Diseases / blood
  • Infant, Premature, Diseases / diagnosis*
  • Infant, Very Low Birth Weight / blood*
  • Logistic Models
  • Male
  • Mean Platelet Volume*
  • Retrospective Studies
  • Risk Factors
  • Treatment Failure


  • Anti-Inflammatory Agents, Non-Steroidal
  • Ibuprofen