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Expectant management of patent ductus arteriosus for preterm infants: A meta-analysis of randomized controlled trials

Huzaifa Ahmad Cheema1, Zuhair Majeed2, Tajamal Hayat2

  • 1Department of Cardiology, King Edward Medical University, Lahore, Pakistan; Department of Medicine, King Edward Medical University, Lahore, Pakistan.

American Heart Journal
|August 11, 2023
PubMed

Insights

Expectant management versus active treatment for patent ductus arteriosus (PDA) in preterm infants showed no difference in mortality or adverse outcomes. Further research is needed to clarify optimal PDA management strategies.

Area of Science:

  • Neonatalogy
  • Pediatric Cardiology
  • Clinical Trials

Background:

  • Patent ductus arteriosus (PDA) is common in preterm infants, posing risks for morbidity and mortality.
  • Current management strategies include expectant management and active closure, with ongoing debate regarding the optimal approach.

Approach:

  • A meta-analysis of 7 randomized controlled trials (RCTs) was performed.
  • The study compared outcomes of expectant management versus active PDA closure in preterm infants.

Key Points:

  • No significant differences in all-cause mortality were observed between expectant management and active PDA treatment.
  • Other clinical adverse outcomes did not differ significantly between the two management strategies.
  • The findings suggest that expectant management may be a viable option for some preterm infants with PDA.

Conclusions:

  • Current evidence does not support a significant difference in major adverse outcomes between expectant management and active PDA closure.
  • Further large-scale, double-blinded RCTs are required.
  • Future research should focus on consistent definitions of hemodynamically significant PDA and high-risk subgroups to refine treatment guidelines.

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