Early paracetamol may speed up heart vessel closure in preterm babies

Early administration of paracetamol may accelerate closure of the patent ductus arteriosus in extremely preterm babies, according to a new study.

Patent ductus arteriosus (PDA) is a common condition in preterm infants in which the foetal blood vessel connection between the aorta and the pulmonary artery does not close normally after birth. The condition can increase the risk of serious illness and mortality, particularly among the smallest preterm infants.

A joint study by the University of Oulu and Oulu University Hospital investigated babies born before 28 weeks of gestation or weighing less than one kilogram at birth. A total of 40 newborns took part in a randomised, double-blind trial in which some received intravenous paracetamol and others a placebo.

The study medication (paracetamol or placebo) was started shortly after birth. The infants first received a loading dose, followed by maintenance doses every six hours for nine days. The status of the ductus arteriosus was assessed before starting the study medication, and its closure was monitored daily using echocardiography.

According to the study, closure of the ductus arteriosus occurred significantly faster in infants who received paracetamol compared with the placebo group. The median time to closure was three days in the paracetamol group and 14 days in the placebo group. There were no differences between the groups in the number of adverse events.

The ductus arteriosus closed during the study in 75 per cent of the infants who received paracetamol, compared with 35 per cent in the placebo group. Three infants in the placebo group required other PDA treatment after the study.

This was an early-stage pilot study, and its results support the benefits and safety of paracetamol in preterm infants. The researchers emphasise the need for larger studies before preventive paracetamol treatment for preterm infants can be included in clinical guidelines.