Prostaglandin Pathway Polymorphisms and HsPDA Treatment Outcomes in Preterm Infants below 32 Weeks: Pilot Study

Despite substantial advances in neonatology, the management of patent ductus arteriosus (PDA) in preterm infants continues to pose a major clinical challenge. The presence of PDA may exacerbate circulatory instability, contribute to tissue hypoxia, and significantly increase the risk of prematurity-related complications. Risk factors for patent ductus arteriosus (PDA), including its hemodynamically significant form (HsPDA), have been consistently associated with lower gestational age, low birth weight, the requirement for invasive mechanical ventilation, and lack of antenatal corticosteroid exposure. With the advent of novel diagnostic approaches, growing attention has been directed toward the genetic determinants of various neonatal conditions. Genetic variability has been extensively documented as a factor influencing drug metabolism, thereby modulating dose-dependent responses and resistance to standard pharmacological interventions.

The study population comprised neonates delivered before 32 completed weeks' gestation to assess the potential impact of polymorphisms in genes associated with the prostaglandin pathway on the response to pharmacological treatment of HsPDA.

Among the identified polymorphisms, one demonstrated a statistically significant association with treatment success. Additional analyses were performed to determine whether therapeutic efficacy differed according to the drug administered.

We propose that further research, particularly studies incorporating diverse ethnic populations, may provide valuable insights into the underlying the pathophysiology of PDA and contribute to the development of more effective treatment strategies.