Effect and Outcome of Paracetamol on PDA in Term and Preterm Sick Newborn in NICU of a Tertiary Care Hospital

Abstract

Background: Patent Ductus Arteriosus (PDA) is a common condition in premature newborn, which often leads to significant morbidity. Traditional treatment, such as COX inhibitors (ibuprofen, indomethacin), represent risks such as necrotizing enterocolitis and kidney damage. Paracetamol, an alternative that inhibits prostaglandin synthesis, has proved to be a promising treatment for the closure of PDA in newborns, but its efficacy in premature versus the term infants remains suspicious. Methods & Materials: This retrospective study evaluated the effect of paracetamol on PDAD closure in 35 neonates in a NICU from January 2023 to December 2023. Inclusion criteria were neonates diagnosed with PAD and treated with paracetamol. PDA size was assessed before and after treatment using echocardiography, with primary outcomes being PDA reduction and secondary outcomes including closure rates and adverse events. Results: Paracetamol significantly reduced PDA size in both term (mean reduction: 2.5 mm) and preterm infants (mean reduction: 1.38 mm). The PDA closure was achieved in 45.7% of cases, with a partial closure of 14.3%. Regression analysis confirmed the positive impact of paracetamol, especially in infants (p <0.001). Premature infants showed less effect of treatment (p = 0.022). Conclusion: Paracetamol is an effective alternative for managing PDA, with term neonates showing greater PDA reduction than preterm infants. These findings suggest that paracetamol could be a promising option for PDA management.