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Clinical and echocardiography predictors of response to first-line acetaminophen treatment in preterm infants with hemodynamically significant patent ductus arteriosus

Journal of Perinatology volume 44, pages 379–387 (2024)Cite this article

Subjects

Abstract

Objective

To assess clinical and echocardiography predictors of acetaminophen response for the treatment of patent ductus arteriosus (PDA) in preterm neonates.

Study design

Retrospective cohort study of preterm infants born <30 weeks, with a diagnosis of hemodynamically significant PDA, who received 1st line treatment with intravenous acetaminophen during the first 2 postnatal weeks. Response was defined by PDA closure or improvement in PDA score of >50%.

Results

A total of 100 infants were included whose median weight and gestational age at birth were 663 grams and 24.6 weeks respectively. In total, 66 infants were classified as responders and were more likely to have intrauterine growth restriction, exposure to maternal hypertension and chorioamnionitis. Non-response was more common among infants with thrombocytopenia and anemia.

Conclusion

Responders were more likely to be IUGR with echocardiography indices of lower preload. Response to 1st line intravenous acetaminophen therapy is comparable to non-steroidal drugs in preterm infants. Relationship of response to acetaminophen to perinatal characteristics requires further characterization.

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Fig. 1: Dot plot comparing PDA score in both groups.
Fig. 2: Relation of responsiveness to Tylenol according to gestational age.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Author information

Author notes

  1. These authors contributed equally: Stephania Cavallaro Moronta, Adrianne R. Bischoff.

Authors and Affiliations

  1. University of Iowa, Department of Pediatrics, Iowa City, IA, USA

    Stephania Cavallaro Moronta, Adrianne R. Bischoff, John M. Dagle, Regan E. Giesinger & Patrick J. McNamara

  2. Indiana University, Department of Epidemiology and Biostatistics, Bloomington, IN, USA

    Kelli K. Ryckman

  3. University of Iowa, Department of Internal Medicine, Iowa City, IA, USA

    Patrick J. McNamara

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SCM-design, data collection, analysis, writing first draft, approving final draft, ARB design, analysis, data collection, analysis, approval of final draft, KKR, JMD, REG, design, approval of final draft, PJM design, analysis, data collection, analysis, approval of final draft.

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Correspondence to Patrick J. McNamara.

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Moronta, S.C., Bischoff, A.R., Ryckman, K.K. et al. Clinical and echocardiography predictors of response to first-line acetaminophen treatment in preterm infants with hemodynamically significant patent ductus arteriosus. J Perinatol 44, 379–387 (2024). https://doi.org/10.1038/s41372-024-01883-w

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