Related Experiment Video
Updated: Jun 16, 2026
Closure of a Patent Foramen Ovale (PFO): An Intervention Sequence
Published on: December 23, 2022
Neurodevelopmental outcome after COX inhibitor treatment for patent ductus arteriosus
C Rheinlaender1, D Helfenstein, C Pees
1Department of Neonatology, Charité, Universitätsmedizin Berlin, Campus Virchow-Klinikum, Germany.
Insights
Cyclooxygenase inhibitor treatment with indomethacin or ibuprofen for hemodynamically significant patent ductus arteriosus (hsPDA) in very low birth weight (VLBW) infants did not impact two-year neurodevelopmental outcomes. Both treatments showed similar closure rates and infant morbidities.
Area of Science:
- Neonatology
- Pediatric Cardiology
- Developmental Pediatrics
Background:
- A hemodynamically significant patent ductus arteriosus (hsPDA) is common in very low birth weight (VLBW) infants.
- Pharmacological closure using cyclooxygenase inhibitors like indomethacin and ibuprofen is a standard treatment.
- Long-term neurodevelopmental outcomes following treatment for hsPDA require further investigation.
Purpose of the Study:
- To compare neurodevelopmental outcomes at two years of corrected age in VLBW infants treated for hsPDA.
- To assess if successful or failed treatment with indomethacin or ibuprofen affects neurodevelopment.
Main Methods:
- Retrospective evaluation of VLBW infants with hsPDA treated with either indomethacin (n=89) or ibuprofen (n=93).
- Comparison of closure rates, early and late morbidities, and neurodevelopmental outcomes between treatment groups.
- Analysis of outcomes in survivors who underwent surgical ligation versus those with successful pharmacological closure.
Main Results:
- Indomethacin and ibuprofen groups had similar baseline characteristics, PDA closure rates (63% vs. 58%), and neurodevelopmental outcomes.
- Therapy failure was associated with lower gestational age and higher mortality.
- No significant difference in neurodevelopmental outcome was observed between survivors treated with medication and those who underwent surgical ligation.
Conclusions:
- Treatment of hsPDA with either ibuprofen or indomethacin does not influence two-year neurodevelopmental outcomes in VLBW infants.
- The choice between indomethacin and ibuprofen for hsPDA closure in VLBW infants does not appear to impact long-term neurodevelopmental results.
Aim:
To compare neurodevelopmental results in very low birth weight (VLBW) infants two years after successful or failed cyclooxygenase inhibitor treatment with either indomethacin or ibuprofen for a haemodynamically significant patent ductus arteriosus (hsPDA).
Methods:
We retrospectively evaluated closure rates and outcome parameters of VLBW infants with hsPDA 89 of whom were treated with indomethacin and 93 with ibuprofen.
Results:
Indomethacin and ibuprofen therapy groups did not differ in their baseline clinical profile (median gestational age 26.0 and 26.2wksd) in early (median CRIB 6 and 5, respiratory distress >2 degrees in 36 and 34 infants) and late morbidities (intraventricular hemorrhage >2 degrees in 9 and 10 infants, bronchopulmonary dysplasia in 31 and 27 infants, 80 and 85 survivors), PDA closure rates (63 and 58%) or neurodevelopmental outcome. The therapy failure group (54 infants) was characterized by lower median gestational age (25.0wksd) and higher mortality (17%). No differences were found in the neurodevelopmental outcome of the surviving infants with ligation as compared to the survivors with successful pharmacological closure of the PDA at 24months corrected age.
Conclusion:
Use of either ibuprofen or indomethacin for closure of a hsPDA did not influence two year neurodevelopmental outcomes in VLBW infants.
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