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Brain Injury and Microstructural Brain Development in Very Preterm Infants with Patent Ductus Arteriosus

Christina Schreiner1, Maria Sappler1, Michaela Höck1

  • 1Department of Pediatrics II (Neonatology), Medical University of Innsbruck, Innsbruck, Austria.

Neonatology
|October 4, 2025
PubMed

Insights

Patent ductus arteriosus (PDA) in preterm infants is not linked to brain injury. While some microstructural differences were observed, they were not significant after adjusting for gestational age.

Area of Science:

  • Neonatal Neuroscience
  • Pediatric Cardiology
  • Developmental Biology

Background:

  • The relationship between patent ductus arteriosus (PDA) and brain development in very preterm infants remains unclear.
  • This study investigates brain injury and microstructural maturation in preterm infants with and without PDA using MRI.

Purpose of the Study:

  • To systematically evaluate brain injury and microstructural brain maturation in very preterm infants with PDA compared to those without.
  • To assess the impact of PDA on brain development at term-equivalent age.

Main Methods:

  • Retrospective, single-center study matching 148 preterm infants with PDA to 148 controls based on gestational age.
  • Cerebral MRI was used to assess brain injury and measure microstructural maturation indicators (fractional anisotropy, apparent diffusion coefficient) in 12 brain regions.

Main Results:

  • No significant differences in overall brain injury rates were found between infants with and without PDA.
  • Microstructural maturation differences were observed in some regions, notably the right middle cerebellar peduncle, but were not significant after adjusting for gestational age.
  • Surgical ligation of PDA was associated with higher rates of cerebellar hemorrhage, severe IVH, and more immature brain maturation patterns.

Conclusions:

  • The presence of PDA is not intrinsically associated with brain injury or impaired brain development in very preterm infants.
  • Gestational age is a critical factor influencing brain development outcomes in this population.
Abstract

Keywords:
Brain injuryBrain maturationDiffusor-tensor imagingMagnetic resonance imagingPatent ductus arteriosusPreterm infants

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