Outcomes of Neonates Born with Symptomatic Tetralogy of Fallot and Absent Ductus Arteriosus.

OBJECTIVE: To test the hypothesis that neonates with symptomatic tetralogy of Fallot (TOF) and absent ductus arteriosus (ADA) have worse clinical outcomes compared with those with a ductus arteriosus (DA), and that this difference is driven by those born with ADA and with critically deficient pulmonary blood flow (CDPBF). STUDY DESIGN: We performed a retrospective, multicenter cohort study of neonates who underwent intervention for symptomatic TOF comparing death and reintervention between subjects with and without a DA identified on fetal echocardiogram or on echocardiogram performed in the first postnatal day. Exclusion criteria were as follows: inability to define DA status, collaterals supplying pulmonary blood flow, atrioventricular septal defect, and absent pulmonary valve. We defined CDPBF as undergoing a procedure to augment pulmonary blood flow on the date of birth or extracorporeal membrane oxygenation prior to such a procedure. RESULTS: The study cohort included 519 patients, among whom 11% had ADA. Patients with ADA were more likely to have a genetic syndrome and had smaller branch pulmonary artery size. In analyses adjusting for center, interventional treatment strategy, genetic syndrome, and minimum branch pulmonary artery size, ADA was associated with higher mortality risk (adjusted hazard ratio of 2.37 (95% CI: 1.07,5.27; P = .034). Seven patients had CDPBF (1.3% of the entire cohort and 12% of patients with ADA). CONCLUSIONS: A minority of symptomatic TOF neonates have ADA, which is associated with higher adjusted mortality risk compared with those with a DA. CDPBF appears to be a rare but important entity in this population.

Maternal supplementation with docosahexaenoic acid does not cause constriction of fetal ductus arteriosus: randomized controlled trial.

OBJECTIVE: Docosahexaenoic acid (DHA) is recommended routinely in pregnancy to promote fetal development. DHA has anti-inflammatory activity, but its effects on the fetal heart and circulation are unknown. This study aimed to investigate whether maternal DHA supplementation in the third trimester affects maternal prostaglandin levels and fetal ductus arteriosus flow dynamics. METHODS: This was a double-blind randomized controlled trial with parallel groups conducted between 2018 and 2021. Pregnant women aged over 18 years with a normal fetus at 27-28 weeks' gestation showing no cardiac/extracardiac anomalies or ductal constriction were eligible for the trial. Women consuming substances with a known inhibitory effect on prostaglandin metabolism, such as non-steroidal anti-inflammatory drugs and polyphenol-rich foods, were excluded. The intervention group received oral supplementation of omega-3 with 450 mg/day of DHA for 8 weeks and the placebo group received capsules of soy lecithin for 8 weeks. Anthropometric measurements, assessment of polyphenol and omega-3 consumption, fetal morphological ultrasound examination, fetal Doppler echocardiographic examination and blood sample collection were performed at the start of the study and the latter two were repeated at follow-up. Prostaglandin E2 (PGE2) level and echocardiographic parameters were compared between the intervention and placebo groups and between baseline and follow-up. RESULTS: A total of 24 participants were included in each group. After 8 weeks, there were no significant differences between the intervention and placebo groups in maternal serum PGE2 level or Doppler echocardiographic parameters of ductal flow. No case of ductus arteriosus constriction was observed. The expected intragroup changes in cardiac morphology, as a result of advancing gestation, were present. CONCLUSIONS: Maternal DHA supplementation in the third trimester at a clinically recommended dose did not result in inhibition of PGE2 or constriction of the ductus arteriosus. These findings should be confirmed in postmarket surveillance studies with larger patient numbers in order to test the full safety profile of DHA and provide robust clinical reassurance. © 2024 International Society of Ultrasound in Obstetrics and Gynecology.

Intravenous prostaglandin E1 (alprostadil) bolus in ductus arteriosus-dependent CHD: valid or absolutely contraindicated?

The use of prostaglandin E1 is well documented in ductus arteriosus-dependent CHD or in neonatal pulmonary pathologies that cause severe pulmonary hypertension. The intravenous infusion is well established in loading infusion and maintenance with an onset of action of 30 minutes until 2 hours or even more. Our aim is to report three patients with pulmonary atresia that presented hypercyanotic spell due to a ductal spasm during cardiac catheterisation in whom the administration of a bolus of alprostadil reversed the spasm and increased pulmonary flow, immediately stabilising the condition of the patients allowing subsequent successful stent placement with no serious complications or sequelae after the administration of the bolus. More studies are needed to make a recommendation regarding the use of alprostadil in bolus in cases where the ductal spasm might jeopardise the life of the patient.

Transcatheter resolution of an aneurism of the pulmonary trunk with residual ductus arteriosus after thoracoscopic clipping: a new approach.

Patent ductus arteriosus is the most common cardiac anomaly in our country. In the last few decades, there has been a lot of interest in developing less invasive techniques like video-assisted thoracoscopic clipping; nevertheless, this also has some complications. We present an 8-year-old female, which had been treated with video-assisted thoracoscopic clipping of patent ductus arteriosus. Five years later, she presented with a large aneurysm of the ductus arteriosus extending to the pulmonary trunk and a residual patent ductus arteriosus. A Cardia ASD occluder of 24 mm was placed in the aneurysm, and the residual ductus arteriosus was then closed with an Amplatzer Plug vascular II device of 10 mm, with a good outcome. The development of an aneurysm after video-assisted patent ductus arteriosus closure is apparently a non-reported complication; therefore, there are also no reports for its treatment. That is why we present this case as an option for its resolution.

Percutaneous Closure of Ductus Arteriosus in Preterm Babies: The Initial Brazilian Experience. / Fechamento Percutâneo do Canal Arterial em Pacientes Prematuros Abaixo de 2 Kg: Experiência Inicial Brasileira.

BACKGROUND: The presence of patent ductus arteriosus can be as high as 50% in preterm babies. Hemodynamically significant patent ductus arteriosus is a common cause of delayed weaning of respiratory support and an important risk factor of necrotizing enterocolitis, intraventricular hemorrhage, and bronchopulmonary dysplasia in this population. OBJECTIVE: The aim of this study is to describe an initial experience of percutaneous closure of the ductus arteriosus in preterm infants weighing less than 2 kg. METHODS: This was a prospective study, comprised of 14 consecutive patients submitted to percutaneous closure of ductus arteriosus between March 2020 and February 2021 in 6 institutions in Brazil. RESULTS: Mean gestational age was 28.45±3.14 weeks, mean age at the procedure was 38.85±17.35 days and mean weight was 1.41 ±0.41 kg; 79% of the patients were under mechanical ventilation, and 79% had been submitted, on average, to a 1.5 cycle of non-steroidal anti-inflammatory drugs. Most patients were weaned off of mechanical ventilation in a mean of 12.6 ±7.24 days after the procedure. Success rate was 100%. No procedure-related mortality was observed. CONCLUSION: This study concluded that percutaneous closure of ductus arteriosus in premature babies below 2 kg has satisfactory results and a low complication rate in this study sample.

FUNDAMENTO: A incidência de ductus arteriosus patente (PCA) pode chegar a 50% em pacientes prematuros. Quando hemodinamicamente significativo, pode ser responsável por tempo de ventilação mecânica prolongado, além de importante fator de risco para o aparecimento de enterocolite necrotizante, hemorragia intraventricular e displasia broncopulmonar nessa população. OBJETIVO: O objetivo deste estudo é descrever a experiência inicial do fechamento percutâneo de canal arterial em prematuros pesando menos de 2 kg. MÉTODOS: Trata-se de estudo prospectivo que compreendeu 14 pacientes consecutivos submetidos a fechamento percutâneo de canal arterial de março de 2020 a fevereiro de 2021 em 6 instituições no Brasil. RESULTADOS: A idade gestacional média ao nascimento foi de 28,45 ±3,14 semanas, a idade média no momento do procedimento foi de 38,85 ±17,35 dias e o peso médio de 1,41±0,41 kg. Dentre os prematuros, 79% necessitavam de ventilação mecânica e 79% tinham feito uso de, em média, 1,5 ciclos de anti-inflamatórios não esteroides. A maioria dos pacientes teve melhora dos parâmetros ventilatórios e o tempo médio de extubação foi de 12,6 ±7,24 dias. A taxa de sucesso foi de 100%. Não houve mortalidade relacionada ao procedimento. CONCLUSÃO: Este estudo concluiu que o fechamento percutâneo do canal arterial em prematuros é uma realidade no Brasil, com resultados satisfatórios e baixa taxa de complicações.

Fechamento percutâneo do canal arterial em pacientes prematuros abaixo de 2 Kg: experiência inicial Brasileira / Percutaneous closure of ductus arteriosus in preterm babies: the initial Brazilian experience

FUNDAMENTO: A incidência de ductus arteriosus patente (PCA) pode chegar a 50% em pacientes prematuros. Quando hemodinamicamente significativo, pode ser responsável por tempo de ventilação mecânica prolongado, além de importante fator de risco para o aparecimento de enterocolite necrotizante, hemorragia intraventricular e displasia broncopulmonar nessa população. OBJETIVO: O objetivo deste estudo é descrever a experiência inicial do fechamento percutâneo de canal arterial em prematuros pesando menos de 2 kg. MÉTODOS: Trata-se de estudo prospectivo que compreendeu 14 pacientes consecutivos submetidos a fechamento percutâneo de canal arterial de março de 2020 a fevereiro de 2021 em 6 instituições no Brasil. RESULTADOS: A idade gestacional média ao nascimento foi de 28,45 ±3,14 semanas, a idade média no momento do procedimento foi de 38,85 ±17,35 dias e o peso médio de 1,41±0,41 kg. Dentre os prematuros, 79% necessitavam de ventilação mecânica e 79% tinham feito uso de, em média, 1,5 ciclos de anti-inflamatórios não esteroides. A maioria dos pacientes teve melhora dos parâmetros ventilatórios e o tempo médio de extubação foi de 12,6 ±7,24 dias. A taxa de sucesso foi de 100%. Não houve mortalidade relacionada ao procedimento. CONCLUSÃO: Este estudo concluiu que o fechamento percutâneo do canal arterial em prematuros é uma realidade no Brasil, com resultados satisfatórios e baixa taxa de complicações.

BACKGROUND: The presence of patent ductus arteriosus can be as high as 50% in preterm babies. Hemodynamically significant patent ductus arteriosus is a common cause of delayed weaning of respiratory support and an important risk factor of necrotizing enterocolitis, intraventricular hemorrhage, and bronchopulmonary dysplasia in this population. OBJECTIVE: The aim of this study is to describe an initial experience of percutaneous closure of the ductus arteriosus in preterm infants weighing less than 2 kg. METHODS: This was a prospective study, comprised of 14 consecutive patients submitted to percutaneous closure of ductus arteriosus between March 2020 and February 2021 in 6 institutions in Brazil. RESULTS: Mean gestational age was 28.45±3.14 weeks, mean age at the procedure was 38.85±17.35 days and mean weight was 1.41 ±0.41 kg; 79% of the patients were under mechanical ventilation, and 79% had been submitted, on average, to a 1.5 cycle of non-steroidal anti-inflammatory drugs. Most patients were weaned off of mechanical ventilation in a mean of 12.6 ±7.24 days after the procedure. Success rate was 100%. No procedure-related mortality was observed. CONCLUSION: This study concluded that percutaneous closure of ductus arteriosus in premature babies below 2 kg has satisfactory results and a low complication rate in this study sample.

Fechamento percutâneo do canal arterial em pacientes prematuros abaixo de 2kg: experiência inicial brasileira / Percutaneous closure of the ductus arteriosus in premature patients weighing less than 2 kg: initial Brazilian experience

FUNDAMENTO: A incidência de ductus arteriosus patente (PCA) pode chegar a 50% em pacientes prematuros. Quando hemodinamicamente significativos, podem ser responsáveis por tempo de ventilação mecânica prolongado, além de importante fator de risco para o aparecimento de enterocolite necrotizante, hemorragia intraventricular e displasia broncopulmonar nesta população. O advento do dispositivo Amplatzer Duct Occluder II Additional Sizes (ADO II AS) (Abbot Structural Heart, Plymouth, MN) revolucionou o tratamento do PCA em pacientes prematuros com menos de 2Kg e, mais recentemente, o dispositivo Piccolotm (Abbot Structural Heart, Plymouth, MN) foi especificamente desenhado para o fechamento percutâneo de canal arterial nesta população e aprovado pelo FDA. OBJETIVO: Descrever a experiência inicial no Brasil do fechamento percutâneo do canal arterial em pacientes prematuros. Delineamento e MÉTODOS: Trata-se de estudo prospectivo, inédito no Brasil, em andamento, que compreendeu 36 pacientes consecutivos submetidos a fechamento percutâneo de canal arterial de março de 2020 a maio de 2022 em 13 instituições no Brasil. RESULTADOS: A idade gestacional média ao nascimento foi de 29,12 semanas (desvio padrão populacional 3,15 e amostral 5,79), a idade média no momento do procedimento foi de 33,50 dias (desvio padrão populacional 15,15 e amostral 15,36) e o peso médio de 1,41Kg (desvio padrão populacional 0,40 e amostral 0,40). Dentre eles, 84% necessitavam de ventilação mecânica e 41% tinham feito uso de, em média, 1,45 ciclos de anti-inflamatórios não esteroides. A maioria dos pacientes teve melhora dos parâmetros ventilatórios e o tempo médio de extubação foi de 14,23 dias (desvio padrão populacional 8,64 e amostral 9,97). A taxa de sucesso foi de 100%. Não houve mortalidade relacionada ao procedimento. CONCLUSÃO: O fechamento percutâneo do canal arterial é um procedimento eficaz e extremamente seguro em pacientes prematuros graves com baixíssima taxa de complicações e associado a melhora dos padrões ventilatórios. Este procedimento é uma realidade no Brasil podendo ser realizado em diversos centros do país que possuem profissionais capacitados para o tratamento percutâneo de cardiopatias congênitas em pacientes prematuros.

Gestational purple grape juice consumption does not change fetal ductus arteriosus constriction in Wistar rats.

Grape juice consumption may influence the early occurrence of ductal constriction during pregnancy, since the consumption of foods rich in polyphenols can be linked to the premature constriction of the ductus arteriosus. This study aimed to evaluate the effect of purple grape juice consumption during gestation on fetal ductus arteriosus closure, prostaglandin levels, and oxidative stress markers in Wistar rats. We divided 18 pregnant rats into four groups: a control group (C), a single-dose grape juice group (SDGJ), a two-dose grape juice group (TDGJ) of 7 µl/g body weight per day, and an indomethacin group (I). Blood was collected on gestational day (GD) 0, 14, and 20. Prostaglandin levels were measured, and the livers and hearts were removed from the mothers and fetuses for oxidative stress analysis; histology of the fetal ductus arteriosus was performed. Prostaglandin levels (pg/ml) at GD 20 were (C:1462.10 ± 314.61); (SDGJ:987.66 ± 86.25); (TDGJ:1290.00 ± 221.57), and (I:584.75 ± 46.77). Fetal ductus arteriosus closure occurred only in the indomethacin group. Lipid peroxidation evaluated through thiobarbituric acid reactive substances (nmol/mg protein) in maternal livers was lower in the grape juice groups (C: 4.11 ± 0.76 nmol/mg protein), (SDGJ: 2.34 ± 0.36), (TDGJ: 1.52 ± 0.18), and (I: 4.20 ± 0.76). Sulfhydryls (nmol/mg protein) were lower in the TDGJ group (C:763.59 ± 61.38 nmol/mg protein), (SDGJ:978.88 ± 158.81), (TDGJ:385.32 ± 86.78), and (I:727.72 ± 49.12). Also, superoxide dismutase activity (USOD/mg protein) was higher in fetal hearts in this group: (C:5.29 ± 0.33), (SDGJ:4.48 ± 0.47), (TDGJ:7.35 ± 0.43), and (I:6.00 ± 0.18). We conclude that grape juice consumption in pregnancy does not induce ductus arteriosus closure in the fetus and presented potential antioxidant effects.

[Stent ductal implant by axillary via in a newborn with ductal dependent pulmonary blood flow]. / Implante de stent ductal por vía axilar en neonato con cardiopatía congénita con flujo pulmonar dependiente del conducto arterioso.

INTRODUCTION: Ductus arteriosus stenting is a palliative alternative for neonates with ductal-dependent pulmonary flow. OBJECTIVE: To present an alternative of arterial access for percutaneous coronary intervention in neonates. CLINICAL CASE: A term neonate with low weight diagnosed with pulmonary atresia with intact ventricular septum and severe hypoplasia of the tricuspid valve with dependent coronary circu lation. Due to the surgical risk and femoral artery damage and the anatomy of the ductus arteriosus, a left axillary arterial puncture was decided where a 3.5-millimeter coronary stent was successfully placed. The patient developed an axillary spasm that resolved spontaneously. CONCLUSION: Alternati ve arterial access other than the femoral artery route is an option for neonates with high surgical risk and low birth weight.

Maternal ingestion of cocoa causes constriction of fetal ductus arteriosus in rats.

Maternal consumption of polyphenol-rich foods has been associated with fetal ductus arteriosus constriction (DAC), but safety of chocolate exposure in fetal life has not been studied. This experimental study tested the hypothesis that maternal cocoa consumption in late pregnancy causes fetal DAC, with possible associated antioxidant effects. Pregnant Wistar rats, at the 21st gestational day, received by orogastric tube cocoa (720 mg/Kg) for 12 h, indomethacin (10 mg/Kg), for 8 h, or only water, before cesaren section. Immediately after withdrawal, every thorax was obtained and tissues were fixed and stained for histological analysis. The ratio of the narrowest part of the pulmonary artery to the fetal ductus inner diameter and increased ductal inner wall thickness characterized ductal constriction. Substances reactive to thiobarbituric acid were quantified. Statistical analysis used ANOVA and Tukey test. Cocoa (n = 33) and indomethacin (n = 7) reduced fetal internal ductus diameter when compared to control (water, n = 25) (p < 0.001) and cocoa alone increased ductus wall thickness (p < 0.001), but no change was noted in enzymes activity. This pharmacological study shows supporting evidences that there is a cause and effect relationship between maternal consumption of cocoa and fetal ductus arteriosus constriction. Habitual widespread use of chocolate during gestation could account for undetected ductus constriction and its potentially severe consequences, such as perinatal pulmonary hypertension, cardiac failure and even death. For this reason, dietary guidance in late pregnancy to avoid high chocolate intake, to prevent fetal ductal constriction, may represent the main translational aspect of this study.

Improvement in fetal pulmonary hypertension and maturity after reversal of ductal constriction: prospective cohort study.

OBJECTIVES: To test the hypotheses that estimated mean pulmonary arterial pressure (MPAP) decreases and pulmonary vascular maturation, assessed by the ratio of pulmonary arterial flow acceleration time to ejection time (AT/ET ratio), increases after reversal of fetal ductus arteriosus constriction by reducing maternal intake of the causal agent (prostaglandin inhibitors, such as polyphenol-rich foods or non-steroidal anti-inflammatory drugs), and that these effects are independent of gestational age, which are inferences not yet demonstrated in the clinical setting. METHODS: This was a prospective cohort study comparing Doppler echocardiographic ductal flow dynamics, MPAP and pulmonary arterial flow AT/ET ratio in third-trimester fetuses (≥ 28 weeks' gestation) with ductus arteriosus constriction, at the time of diagnosis and after 2 weeks of reduced maternal intake of prostaglandin inhibitors either by suspending the use of pharmacological agents with potential for prostaglandin inhibition or by restricting the consumption of polyphenol-rich foods. MPAP was estimated using the Dabestani equation (MPAP = 90 - (0.62 × AT)), and pulmonary vascular maturity was assessed using the AT/ET ratio, according to reported validation studies. Student's t-test was used for comparison of variables at diagnosis with those after reversal of ductal constriction. Change in MPAP and pulmonary AT/ET ratio between the two assessments was compared with the expected change in the same gestational period in normal fetuses based on reference curves of MPAP and pulmonary AT/ET ratio constructed in normal fetuses from healthy pregnant women at 19-37 weeks' gestation, encompassing the same gestational age range as the study group (28-37 weeks). RESULTS: Seventy pregnancies with fetal ductus arteriosus constriction were included in the study. After 2 weeks of reduced maternal intake of prostaglandin inhibitors, normalization of mean systolic (change from 1.86 ± 0.34 m/s at diagnosis to 1.38 ± 0.41 m/s; P < 0.001) and diastolic (change from 0.41 ± 0.11 m/s to 0.21 ± 0.065 m/s; P < 0.001) ductal velocities and of mean pulsatility index (change from 1.99 ± 0.20 to 2.55 ± 0.42; P < 0.001) was demonstrated. MPAP decreased between the assessments (change from 66.7 ± 6.90 mmHg at diagnosis to 54.5 ± 6.70 mmHg after 2 weeks; P < 0.001) and mean pulmonary AT/ET ratio increased (change from 0.20 ± 0.06 to 0.33 ± 0.07; P < 0.001). Change in MPAP between diagnosis and after 2 weeks of reduced maternal intake of prostaglandin inhibitors was -12.2 ± 0.30 mmHg, which was 5.3-times higher than that in 305 normal fetuses over 2 weeks during the same gestational period (-2.3 ± 0.19 mmHg) (P < 0.001), and change in pulmonary AT/ET ratio between the two assessments was 0.13 ± 0.08, which was 8.7-times higher than that in normal fetuses in the same gestational period (0.015 ± 0.08) (P < 0.001). CONCLUSIONS: Resolution of fetal ductal constriction is followed by a fall in MPAP and by an increase in pulmonary vascular maturity, to a significantly greater degree than is observed in normal fetuses in the same gestational-age period. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.

Unusual Presentation of Patent Ductus Arteriosus in Elderly Patient.

We presented a case of a 56-year-old man with giant pulmonary artery aneurysm caused by a misdiagnosed patent ductus arteriosus, severe multivalvular disease and active aortic valve endocarditis successfully treated by surgery. The correct diagnosis was missed despite preoperative diagnostics because the small patent ductus arteriosus was located at the distal part of common pulmonary trunk and a huge regurgitant signal overlapped its Doppler signal. Thorough evaluation of every patient, regardless of age, is necessary to recognize and treat this congenital anomaly.

Unusual presentation of patent ductus arteriosus in elderly patient

Abstract We presented a case of a 56-year-old man with giant pulmonary artery aneurysm caused by a misdiagnosed patent ductus arteriosus, severe multivalvular disease and active aortic valve endocarditis successfully treated by surgery. The correct diagnosis was missed despite preoperative diagnostics because the small patent ductus arteriosus was located at the distal part of common pulmonary trunk and a huge regurgitant signal overlapped its Doppler signal. Thorough evaluation of every patient, regardless of age, is necessary to recognize and treat this congenital anomaly.

Aspectos desconocidos de la relación entre el sistema de grupo sanguíneo ABO y las morbilidades en prematuros / Unknown aspects of the relationship between ABO blood group system and preterm morbidities

Objetivos. Se ha demostrado, en diversos estudios llevados a cabo en adultos, que los grupos sanguíneos desempeñan un papel importante en muchas enfermedades. El objetivo fue investigar si hay una relación entre las morbilidades y el sistema de grupos sanguíneos ABO en lactantes prematuros.Metodología. En este estudio de cohorte retrospectivo, se incluyó a recién nacidos prematuros que habían nacido con menos de 32 semanas de gestación y con un peso al nacer inferior a 1500 g. Se los agrupó por grupo sanguíneo (0, A, B, AB) y por morbilidades de la prematurez y se los comparó.Resultados. Se analizaron los datos de 1785 recién nacidos prematuros de muy bajo peso al nacer. La comparación entre los grupos sanguíneos A y no A reveló que los lactantes de grupo sanguíneo A tenían una incidencia más alta de conducto arterial persistente (CAP) (48,7 % frente a 39,7 %, p = 0,005) y displasia broncopulmonar (DBP) (27 % frente a 20,8 %, p = 0,04), mientras que la incidencia de la hemorragia intraventricular de grado ≥3 era más baja (5,1 % frente a 10,1 %, p = 0,006).Conclusión. Este estudio es la primera y más grande investigación sobre la relación entre los grupos sanguíneos y las morbilidades en los prematuros. Con estos resultados se demuestra que el grupo sanguíneo A podría ser un factor de riesgo de CAP y DBP

Objectives. Blood groups have been shown to play an important role in a lot of diseases in various studies conducted in adults. The objective was to investigate whether there is a relationship between morbidities and ABO blood groups system in preterm infants.Methodology. This retrospective cohort study included preterm neonates born at < 32 weeks of gestation with a birth weight < 1500 g. Neonates were grouped by blood type (O, A, B, AB) and morbidities of prematurity were compared among these groups. Results. Data pertaining to 1785 very low birth weight preterm neonates were analyzed. Comparison of the A and non-A blood groups revealed that infants with blood group A had significantly higher incidence of patent ductus arteriosus (PDA) (48.7 % vs. 39.7 %, p = 0.005) and bronchopulmonary dysplasia (BPD) (27 % vs. 20.8 %, p = 0.04), while the incidence of grade ≥ 3 intraventricular hemorrhage was lower (5.1 % vs. 10.1 %, p = 0.006).Conclusion. This study represents the first and biggest series examination of the relationship between blood groups and preterm morbidities. Our results show that blood group A may be a risk factor for PDA and BPD.