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Immunopathol Persa. 2022;x(x):e29291 Original
Platelet counts and C-reactive protein in preterm
infants with patent ductus arteriosus
Mohammad Reza Aramesh
ID
, Arash Malakian
ID
, Mohsen Hosseinzadeh
ID
, Masoud Dehdashtian
ID
, Mohammad Rostami
Shahrebabaki
*
ID
Department of Neonatal Intensive Care Unit, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Immunopathologia Persa
http www.immunopathol.com
*Correspondence to
Mohammad Rostami
Shahrebabaki, Email:
mohammaderostami@gmail.
com, rostami.m@ajums.ac.ir
Received 19 Sep. 2021
Accepted 9 Nov. 2021
Published online 9 June 2022
Keywords: Patent ductus
arteriosus, Platelet, C-reactive
protein, Preterm infants
Introduction: Patent ductus arteriosus (PDA) is a common disorder in premature infants which causes heart
failure. Platelets and C-reactive protein (CRP) play an important role in closure.
Objectives: The purpose of this study was to evaluate serum CRP and plasma platelet count in preterm infants with
PDA compared to infants without PDA.
Patients and Methods: This case-control study was conducted on premature infants with PDA admitted to Imam
Khomeini hospital in Ahvaz, Iran (2020-2021). A group of 120 infants with inclusion criteria was selected and
divided into two groups of 60 subjects. The preterm infant with PDA and without PDA was defined as the case
and control group, respectively. Platelet count, serum CRP, and an echocardiogram were assessed in all infants.
The subjects were matched by gender, gestational age, and birth weight.
Results: The mean platelet count was 194.67±74.03 (×10
3
/mm
3
) in the neonate with PDA, and it was significantly
lower than in neonate without PDA (P=0.04). The mean of serum CRP was significantly different in neonates with
PDA (11.62±5.96 mg/L) compared to neonates with closed arterial ducts (8.52±3.97 mg/L; P=0.002). Additionally,
PDA was associated with high platelet distribution width (PDW).
Conclusion: The findings of this study revealed that PDA is associated with a low-number of platelets and high
serum levels of CRP in preterm neonates. It is suggested that further studies with a higher sample size on platelet
count and/or function be performed in PDA patients to understanding more about the cause of PDA and to
discover novel and beneficial aims in these cases.
Abstract
Citation: Aramesh
MR, Malakian A,
Hosseinzadeh M,
Dehdashtian M,
Rostami Shahrebabaki
M. Platelet counts and
C-reactive protein in
preterm infants with
patent ductus arteriosus.
Immunopathol Persa.
2022;x(x):e29291.
DOI:10.34172/
ipp.2022.29291.
Introduction
The ductus arteriosus is the connection
between the aorta and the pulmonary artery
and is necessary for the fetus survival (1). After
birth, this duct must be closed due to changes
in the fetal to neonatal blood circulation (2).
Ductal closure failure in premature babies is
a mystery that infants have confronted for a
long time, while the pathophysiological and
scientific consequences have not yet been
resolved (3-5).
The exact mechanism of ductal constriction
remains controversial (6). Patent ductus
arteriosus (PDA) is the main challenge in
preterm infants in neonatal intensive care
units (7). Additionally, the endurance of
PDA in premature infants causes severe
hemodynamic modifications that sometimes
result in death(8).
Several previous studies suggested that
inflammation plays a critical function in
the pathogenesis of PDA (9, 10). It has been
shown that serum C-reactive protein (CRP)
levels are higher in preterm infants with PDA
Key point
Patent ductus arteriosus (PDA) is one of the most
common congenital heart diseases that causes serious
hemodynamic changes and sometimes leads to death
in preterm neonates. Based on our findings, PDA is
associated with a low number of platelets and high
levels of C-reactive protein in preterm neonates.
(9). Moreover, several studies have reported
that impaired platelet linkage or transgenic
failings in its biogenesis lead to determine of
ductus arteriosus (7).
Echtler et al showed an essential role of
platelets in postnatal ductus arteriosus closure
in a mouse model. They also reported that
thrombocytopenia may have a critical role in
rising the risk for failure of ductus arteriosus
closure in premature newborns(11). There is
few human studies on the association of CRP
and platelet levels with PDA (1).
Objectives
Considering the importance of this disease,
we decided to conduct this study with the
DOI:10.34172/ipp.2022.29291