Pediatrics
Study examines safety of acetaminophen for PDA closure in preterm infants
Compared with cyclooxygenase (COX) inhibitors, use of acetaminophen for the treatment of patent ductus arteriosus (PDA) in very preterm infants didn't significantly increase the risk of in-hospital respiratory complications. However, an association between acetaminophen and mortality warrants further investigation.
- For this retrospective cohort study, 1,921 preterm infants who'd received acetaminophen, ibuprofen, and/or indomethacin for PDA closure were identified from the National Institute of Child Health and Human Development Neonatal Research Network. Primary outcome was death or grade 2-3 bronchopulmonary dysplasia (BPD) at 36 weeks' postmenstrual age. Secondary outcomes included predischarge mortality and respiratory morbidities.
- In total, 32.6% received acetaminophen and 67.3% received COX inhibitors. Multidrug therapy (42.9% vs. 4.7%) and surgical or catheter PDA closure (26.5% vs. 19.9%) were more common among acetaminophen-exposed infants.
- Death or grade 2 to 3 BPD at 36 weeks' postmenstrual age was similar between infants treated with acetaminophen vs. COX inhibitor only (57.1% vs. 58.3%). Acetaminophen was associated with increased risk of predischarge mortality (13.3% vs. 10.0%) when adjusting for perinatal and early postnatal factors but not in exploratory analyses that included later postnatal factors.
Source:
Jensen EA, et al; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. (2024, July 16). Pediatrics. Acetaminophen for Patent Ductus Arteriosus and Risk of Mortality and Pulmonary Morbidity. https://pubmed.ncbi.nlm.nih.gov/39011550/