Predictors of successful patent ductus arteriosus closure with acetaminophen in preterm infants

Abstract

Objective: Evaluate predictors of successful PDA closure following acetaminophen treatment. Study design: Retrospective cohort study of ≤30 weeks GA infants born from 1 January 2013–30 September 2019, and treated with single course acetaminophen by symptomatic PDA treatment strategy. Multiple maternal and neonatal variables were identified as potential predictors. Univariate analysis and multivariable regression models were applied to evaluate the strongest predictors. Results: Sixty-six patients were included, 28 (42.4%) had successful PDA closure following acetaminophen. Success was associated with GA > 26 weeks (65% vs. 33%, AUC = 0.64), birthweight >750 g (53% vs. 32%, AUC = 0.61), PDA size ≤0.2 cm (63% vs. 32%, AUC = 0.64), and no prior indomethacin use (56% vs. 33%, AUC = 0.61). Multivariable model identified GA > 26 weeks (RR = 1.92, CI 1.20–3.09) and PDA size ≤0.2 cm (RR: 1.82, CI 1.11–2.98) as the strongest predictors. Conclusion: Acetaminophen may be more successful in targeted PDA closure in >26 weeks GA infants with PDA size ≤0.2 cm.