Trial of Selective Early Treatment of Patent Ductus Arteriosus With Ibuprofen

Abstract

(N Engl J Med. 2024;390(4):314–325) In the past 20 years, survival rates among exceedingly premature neonates have risen. There is also a documented slight decrease in neonatal illness in the same time period, although bronchopulmonary dysplasia rates have climbed. Among exceedingly premature neonates, a patent ductus arteriosus (PDA) with a diameter of at least 1.5 mm persisting beyond 72 hours after birth correlates with heightened mortality, morbidity, and a greater chance of bronchopulmonary dysplasia compared with infants without a PDA. The occurrence of PDA declines as gestational age decreases. The risk of bronchopulmonary dysplasia or death in exceedingly premature neonates also rises with PDA persisting beyond 1 to 2 weeks after birth.