The persistence of a patent ductus arteriosus (PDA) is much more common in preterm than full-term infants.[2]Moore P, Brook MM, Heymann MA. Patent ductus arteriosus. In: Moss and Adams heart disease in infants, children and adolescents. Philadelphia, PA: Lippincott, Williams and Wilkins; 2001. This is secondary to the immaturity of the ductus.[3]Gittenburger-De Groot AC, van Ertbruggen I, Moulaert AJ, et al. The ductus arteriosus in the preterm infant: histologic and clinical observations. J Pediatr. 1980;96:88-93.
http://www.ncbi.nlm.nih.gov/pubmed/7350322?tool=bestpractice.com
Since the advent of echocardiography, the incidence of PDA in children born at full-term has been reported as approximately 1 to 2 per 1000.[4]Botto LD, Correa A, Erickson JD. Racial and temporal variations in the prevalence of heart defects. Pediatrics. 2001;107:E32.
http://pediatrics.aappublications.org/content/107/3/e32.full
http://www.ncbi.nlm.nih.gov/pubmed/11230613?tool=bestpractice.com
This estimate is higher than previously thought because it includes clinically silent PDAs.[5]Lloyd TR, Beekman RH III. Clinical silent patent ductus arteriosus. Am Heart J. 1994;127:1664-1665. There is globally a higher incidence in females as well as in children born at higher altitudes.[6]Rothman KJ, Fyler DC. Sex, birth order, and maternal age characteristics of infants with congenital heart defects. Am J Epidemiol. 1976;104:527-534.
http://www.ncbi.nlm.nih.gov/pubmed/984027?tool=bestpractice.com
[7]Miao CY, Zuberbuhler JS, Zuberbuhler JR. Prevalence of congenital cardiac anomalies at high altitude. J Am Coll Cardiol. 1988;12:224-228.
http://www.ncbi.nlm.nih.gov/pubmed/3379209?tool=bestpractice.com
In the US, there is also a racial differential, with a higher incidence found in black children compared with white children.[4]Botto LD, Correa A, Erickson JD. Racial and temporal variations in the prevalence of heart defects. Pediatrics. 2001;107:E32.
http://pediatrics.aappublications.org/content/107/3/e32.full
http://www.ncbi.nlm.nih.gov/pubmed/11230613?tool=bestpractice.com
In premature infants, the incidence is substantially greater. Studies in the US have shown an incidence as high as 20% in premature infants weighing <1750 g and 64% in those weighing <1000 g.[8]Gersony WM, Peckham GJ, Ellison RC, et al. Effects of indomethacin in premature infants with patent ductus arteriosus: results of a national collaborative study. J Pediatr. 1983 Jun;102(6):895-906.
http://www.ncbi.nlm.nih.gov/pubmed/6343572?tool=bestpractice.com
[9]Koch J, Hensley G, Roy L, et al. Prevalence of spontaneous closure of the ductus arteriosus in neonates at a birth weight of 1000 grams or less. Pediatrics. 2006;117:1113-1121.
http://www.ncbi.nlm.nih.gov/pubmed/16585305?tool=bestpractice.com
Research indicates that socioeconomic disparities can delay the diagnosis of PDA and access to care, which, in turn, affects neurodevelopment outcomes, underscoring the need for addressing these disparities to improve long-term outcomes for affected children.[10]Sood E, Newburger JW, Anixt JS, et al. Neurodevelopmental outcomes for individuals with congenital heart disease: updates in neuroprotection, risk-stratification, evaluation, and management: a scientific statement from the American Heart Association. Circulation. 2024 Mar 26;149(13):e997-1022.
https://www.ahajournals.org/doi/full/10.1161/CIR.0000000000001211
http://www.ncbi.nlm.nih.gov/pubmed/38385268?tool=bestpractice.com