HMN 2026: How Early paracetamol treatment may speed closure of preterm infants’ ductus arteriosus

Patent ductus arteriosus (PDA) is a common condition in preterm infants in which the fetal blood vessel connection between the aorta and the pulmonary artery does not close normally after birth. The condition can increase the risk of serious illness and death, particularly among the smallest preterm infants.

A joint study by the University of Oulu and Oulu University Hospital, now published in Neonatology, investigated babies born before 28 weeks of gestation or weighing less than 1 kilogram at birth. A total of 40 newborns took part in a randomized, double-blind trial in which some received intravenous paracetamol and others received a placebo.

The study medication, paracetamol or placebo, was started shortly after birth. The infants first received a loading dose, followed by maintenance doses every six hours for nine days. The status of the ductus arteriosus was assessed before the study medication began, and its closure was monitored daily using echocardiography.

According to the study, closure of the ductus arteriosus occurred significantly faster in infants who received paracetamol than in the placebo group. The median time to closure was three days in the paracetamol group and 14 days in the placebo group. There were no differences between the groups in the number of adverse events.

The ductus arteriosus closed during the study in 75% of the infants who received paracetamol, compared with 35% of those in the placebo group. Three infants in the placebo group required other PDA treatment after the study.

This was an early-stage pilot study, and its results support the benefits and safety of paracetamol in preterm infants. The researchers emphasized the need for larger studies before preventive paracetamol treatment for preterm infants can be included in clinical guidelines.

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