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Patent Ductus Arteriosus Persistence and Neurodevelopmental Outcomes: A Restrictive Treatment Approach Does Not
Moses Kallenberger1, Alina Bartling1, Britta Hüning1,2
1Department of Pediatrics I, Neonatology, Pediatric Intensive Care, Pediatric Infectiology and Pediatric Neurology, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
Acta Paediatrica (Oslo, Norway : 1992)
|March 20, 2026
Summary
Patent ductus arteriosus (PDA) duration did not significantly impact neurodevelopment in very preterm infants. Gestational age and comorbidities were the primary determinants of outcomes in this cohort.
Area of Science:
- Neonatalogy
- Developmental Pediatrics
- Cardiology
Background:
- Patent ductus arteriosus (PDA) management in preterm infants is debated.
- The impact of PDA duration on neurodevelopmental outcomes requires further investigation.
Purpose of the Study:
- To investigate the influence of PDA duration on neurodevelopmental outcomes in preterm infants treated restrictively.
- To determine if PDA duration affects neurodevelopment independently of gestational age and comorbidities.
Main Methods:
- Retrospective study of 171 preterm infants (≤32 weeks gestation) with or without PDA.
- Neurodevelopmental assessments included cerebral MRI, General Movement Assessment, and Bayley Scales of Infant Development III.
- Infants with severe IVH (≥III°) were excluded.
Main Results:
- Infants with hemodynamically significant PDA (hsPDA) had lower gestational age, birth weight, and higher rates of bronchopulmonary dysplasia.
- PDA duration showed a weak association with mild IVH (≤II°) in the hsPDA subgroup.
- Multivariate analysis revealed no significant impact of PDA group or duration on neurodevelopmental outcomes after adjusting for confounders.
Conclusions:
- Gestational age and comorbidities, not PDA duration, were the key factors influencing neurodevelopmental outcomes.
- Restrictive PDA treatment approaches may mitigate the direct impact of PDA duration on neurodevelopment in preterm infants without severe brain injury.
