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Patent Ductus Arteriosus Persistence and Neurodevelopmental Outcomes: A Restrictive Treatment Approach Does Not Compromise Neurological Development

Year: 2026

Type: article

Abstract: AIM: Optimal treatment strategies for patent ductus arteriosus (PDA) and their impact on neurodevelopmental outcomes remain controversial. This study investigates the influence of PDA duration on neurodevelopment under a restrictive treatment approach. METHODS: Retrospective single-center study of 171 preterm infants ≤ 32 weeks gestation with echocardiographically-identified PDA (treated hemodynamically significant PDA-hsPDA, untreated PDA-ntPDA) or no PDA. Assessments included cerebral MRI at term-equivalent age, General Movement Assessment at 8-16 weeks and Bayley Scales of Infant Development III at 22-26 months corrected age. Infants with severe IVH ≥ III° were excluded a priori to isolate PDA effects without major brain injury. RESULTS: The hsPDA group represented infants with lower gestational age and birth weight, higher rates of bronchopulmonary dysplasia and longer hospitalization (all p < 0.001). Transcerebellar diameter differed significantly between groups (p = 0.004). PDA duration showed a statistical association with MRI-detected IVH ≤ II° in the hsPDA subgroup (OR 1.01 per day, p = 0.05). Multivariate analysis did not confirm any significant impact of PDA group or duration on neurodevelopmental outcomes after adjusting for confounders. CONCLUSION: Gestational age and comorbidities, rather than longer PDA duration, determined neurodevelopmental outcomes in our cohort of very preterm infants without severe brain injury.

Source: Acta Paediatrica

DOI: 10.1111/apa.70511