C-reactive protein and Platelets changes in preterm neonates with patent Ductus Arteriosus

Document Type: Original Article

Authors

1 Assistant Professor, Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran

2 Afzalipour Medical Center, Kerman University of Medical Sciences, Kerman, Iran

3 Professor, Department of Pediatrics, Kerman University of Medical Sciences, Kerman, Iran

4 Assistant Professor, Department of Pediatrics, Kerman University of Medical Sciences, Kerman, Iran

Abstract

Introduction: This study aimed to investigate CRP and platelet count changes in preterm neonates with Patent Ductus Arteriosus on the seventh day of birth compared to the third day.
Methods: This longitudinal study was conducted on fifty neonates with PDA complications in Afzalipour hospital in 2017-2018. All neonates underwent repeated echocardiography before the closure of their arterial duct and 2 cc of blood sample was taken from each neonate and was sent to the laboratory for platelet and CRP count test.
Result: The mean of platelet was 296.17±18.08 on day 7, and it was significantly different compared to day 3 (195.49 ± 10.49). The arterial ducts of 15 neonates out of 50 patients with PDA were closed on the seventh day. The mean of CRP was significantly different in neonates with PDA (35.70) compared to neonates with closed arterial ducts (2.32) on day 7.
Conclusions: The results of this study revealed that PDA is associated with a low number of platelets and high level of CRP in preterm neonates.

Keywords


  1. Zahka KG, Erenberg F. Fanaroff and Martin's Neonatal Perinatal Medicine. 2011; St. Louis, MO: Elsevier Mosby.
  2. Van Overmeire B, Chemtob S. The pharmacologic closure of the patent ductus arteriosus. Semin Fetal Neonatal Med 2005; 10(2):177-84.
  3. Van Overmeire B, Smets K, Lecoutere D, Van de Broek H, Weyler J, Degroote K, et al. A comparison of ibuprofen and indomethacin for closure of patent ductus arteriosus. N Engl J Med 2000; 343(10):674-81.
  4. Supapannachart S, Limrungsikul A, Khowsathit P. Oral ibuprofen and indomethacin for treatment of patent ductus arteriosus in premature infants: a randomized trial at Ramathibodi Hospital. J Med Assoc Thai 2002; 85(Suppl 4):S1252-8.
  5. Kulkarni VV, Dutta S, Sandaram V, Saini SS. Preterm throbocytopenia and delay of ductus arteriosus closure. Pediatrics 2016; 138(4):e20161627.
  6. Rifai N, Buring JE, Lee IM, Manson JE, Ridker PM. Is C - reactive protein specific for vascular disease in women? Ann Intern Med 2002; 136(7):529-33.
  7. Meinarde L, Hillman M, Rizzotti A, Basquiera AL, Tabares A, Cuestas E. C- eactive protein, platlets and patent ductus arteriosus. Platelets 2016; 27(8):821-23.
  8. Echtler K1, Stark K, Lorenz M, Kerstan S, Walch A, Jennen L, et al. Platelets contribute to postnatal occlusion of the ductus arteriosus. Nat Med 2010; 16(1):75-82.
  9. Clyman R, Chemtob S. Vessel remodeling in the newborn: platelets fill the gap. Nat Med 2010; 16(1):33-5.
  10. Boo NY, Mohd-Amin I, Bilkis AA, Yong-Junina F. Predictors of failed closure of patent ductus arteriosus with indomethacin. Singapore Med J 2006; 47(9):763-8.
  11. Shah NA, Hills NK, Waleh N, McCurnin D, Seidner S, Chemtob S, et al. Relationship between circulating platelet counts and ductus arteriosus patency after indomethacin treatment. J Pediatr 2011; 158(6):919-23.
  12. Fujioka K, Morioka I, Miwa A, Morikawa S, Shibata A, Yokoyama N, et al. Does thrombocytopenia contribute to patent ductus arteriosus? Nat Med 2011; 17(1):29-30.
  13. Sallmon H, Weber SC, von Gise A, Koehne P, Hansmann G. Ductal closure in neonates: a developmental perspective on platelet–endothelial interactions. Blood Coagul Fibrinolysis 2011; 22(3):242-4.
  14. Waleh N, Seidner S, McCurnin D, Yoder B, Liu BM, Roman C, et al. The role of monocyte-derived cells and inflammation in baboon ductus arteriosus remodeling. Pediatr Res 2005; 57(2):254-62.
  15. Silver MM, Freedom RM, Silver MD, Olley PM. The morphology of the human newborn ductus arteriosus: a reappraisal of its structure and closure with special reference to prostaglandin E1 therapy. Hum Pathol 1981; 12(12):1123-36.
  16. Dani C, Poggi C, Fontanelli G. Relationship between platelet count and volume and spontaneous and pharmacological closure of ductus arteriosus in preterm neonatess. Am J Perinatol 2013; 30(5): 359-64.
  17. Alyamac Dizdar E, Ozdemir R, Sari FN, Yurttutan S, Gokmen T, Erdeve O, et al. Low platelet count is associated with ductus arteriosus patency in preterm newborns. Early Hum Dev 2012; 88(10): 813-6.
  18. Hillman M, Meinarde L, Rizzotti A, Cuestas E, et al. Inflammation, high-sensitivity c-reactive protein, and persistent patent ductus arteriosus in preterm infants. Revista Española de Cardiología 2016; 69(1):84-5.