Expectant Management vs Medication for Patent Ductus Arteriosus in Preterm Infants

Among preterm infants born at 22 to 28 weeks’ gestation with a protocol-defined patent ductus arteriosus, does expectant management compared with active treatment (pharmacological treatment with acetaminophen, ibuprofen, or indomethacin) decrease the incidence of death or bronchopulmonary dysplasia (BPD)?In this multicenter, randomized clinical trial, the incidence of death or BPD at 36 weeks’ postmenstrual age was not different between groups (80.9% in expectant management group vs 79.6% in active treatment group). However, the incidence of death by 36 weeks’ postmenstrual age was lower in the expectant management group than in the active treatment group (4.1% vs 9.6%, respectively).The incidence of death or BPD was not different between groups, but more infants survived in the expectant management group.

Corresponding Author: Matthew M. Laughon, MD, MPH, UNC Hospitals, 101 Manning Dr, Chapel Hill, NC 27599 (matt_laughon@med.unc.edu).

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