Comparing the effect of acetaminophen and ibuprofen on patent ductus arteriosus closure in preterm newborns

Abstract

Background: A considerable rate of neonatal mortality is associated with the function of patent ductus arteriosus (PDA) closure. The present study aimed to find how Ibuprofen affected PDA closure in preterm neonates compared to Acetaminophen and controls.

Methods: This clinical trial reviewed 327 neonates with a gestational age of less than 37 weeks and a birth weight of below 2500 grams. Participants were randomly assigned to three groups: receiving ibuprofen, acetaminophen, and controls. Echocardiography was performed on the third day after birth and on the first day following the conclusion of treatment. Data analysis was conducted using SPSS 22, with a significance level less than 0.05. 

Results: A total of 327 preterm infants were evaluated. Significant differences in PDA closure were observed in Ibuprofen (p = 0.012) compared to other groups. For neonates with a gestational age above 32 weeks, the ibuprofen group had a significantly higher PDA closure rate compared to the acetaminophen group, achieving 100% closure (46 cases, p < 0.05). A similar trend was observed between the ibuprofen and control groups (χ² = 9.244, p = 0.002), with ibuprofen showing superior outcomes. For neonates weighing above 1500 grams, significant differences emerged, specifically, in the acetaminophen-ibuprofen groups (x² = 4.35, p = 0.04), the acetaminophen-control (χ² = 3.5, p = 0.05), and control-ibuprofen (χ² = 12.89, p < 0.001). Ibuprofen consistently showed higher PDA closure rates. Binary logistic regression showed that PDA closure was significantly associated with treatment type and pre-treatment PDA size, while sex, gestational age, and birth weight had no significant effect.

Conclusion: It has been concluded that Ibuprofen had a greater impact on PDA closure. The Ibuprofen administration demonstrated superior outcomes in preterm infants with a gestational age exceeding 32 weeks and a weight at birth exceeding 1500 grams.