Early administration of paracetamol may accelerate the closure of patent ductus arteriosus in very preterm infants, according to a new study.
Patent ductus arteriosus (PDA) is a common condition in premature infants in which the fetal vascular connection between the aorta and pulmonary artery does not close properly after birth. This condition can increase the risk of serious illness and death, especially in the smallest preterm infants.
A joint study by the University of Oulu and Oulu University Hospital looked at babies born before 28 weeks of gestation or weighing less than 1 kg at birth. A total of 40 newborns took part in the randomized, double-blind trial, with some receiving intravenous paracetamol and others receiving a placebo.
Study medication (paracetamol or placebo) was started immediately after birth. Infants were initially given a loading dose, followed by maintenance doses every 6 hours for 9 days. The status of the ductus arteriosus was assessed before starting study drug administration, and ductus arteriosus closure was monitored daily using echocardiography.
According to the study, closure of the ductus arteriosus occurred significantly earlier in infants who received paracetamol compared to the placebo group. Median time to closure was 3 days in the paracetamol group and 14 days in the placebo group. The number of adverse events did not differ between groups.
The ductus arteriosus closed during the study in 75% of infants given paracetamol compared to 35% of those in the placebo group. Three infants in the placebo group required another PDA treatment after the study.
This is an early-stage pilot study, and the results support the benefits and safety of paracetamol for preterm infants. The researchers emphasize that larger studies are needed before prophylactic paracetamol treatment for preterm infants can be incorporated into clinical guidelines.
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Reference magazines:
Ukonen, T. others. (2026). Long-term prophylactic administration of low-dose paracetamol promotes ductal closure in very preterm neonates: a randomized trial. Neonatology. DOI: 10.1159/000552204. https://karger.com/neo/article/doi/10.1159/000552204/949015/Long-term low-dose paracetamol prophylaxis
