Download PDF
Am J Perinatol 2017; 34(12): 1185-1189
DOI: 10.1055/s-0037-1601564
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Neurodevelopmental Outcomes of Preterm Infants Treated with Oral Paracetamol Versus Ibuprofen for Patent Ductus Arteriosus

Mehmet Yekta Oncel
1   Division of Neonatology, Department of Pediatrics, Katip Çelebi University, İzmir, Turkey
2   Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey
,
Zeynep Eras
3   Developmental Behavioral Pediatrics Unit, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey
,
Nurdan Uras
2   Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey
,
Fuat Emre Canpolat
2   Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey
,
Omer Erdeve
4   Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
,
Serife Suna Oguz
2   Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey
› Author Affiliations
Further Information

Publication History

16 August 2016

27 February 2017

Publication Date:
10 April 2017 (online)

Also available at
    Permissions and Reprints

Abstract

Objective This study aims to determine the effects of paracetamol versus ibuprofen treatment given to preterm infants for the pharmacological closure of patent ductus arteriosus (PDA) on neurodevelopmental outcomes at 18 to 24 months' corrected age.

Method A follow-up study was conducted to evaluate the neurodevelopmental outcomes of preterm infants (gestational age ≤ 30 weeks) enrolled in a randomized controlled trial comparing oral paracetamol versus oral ibuprofen for the closure of PDA. The developmental assessment was done by using “Bayley Scales of Infant Development, Second Edition” at 18 to 24 months' corrected age.

Results A total of 80 infants completed the trial protocol. Of the 75 infants eligible for follow-up, 61 infants (30 in the paracetamol group and 31 in the ibuprofen group) were evaluated. There was no significant difference in neurodevelopmental outcomes between the two groups.

Conclusion The neurodevelopmental outcomes did not differ among the preterm infants who receive either paracetamol or ibuprofen at 18 to 24 months' corrected age.

Keywords

ibuprofen - neurodevelopmental outcome - paracetamol - patent ductus arteriosus - preterm infant

ClinicalTrials.gov Number of the Original Publication

NCT01536158


 

  • References

  • 1 Oncel MY, Erdeve O. Safety of therapeutics used in management of patent ductus arteriosus in preterm infants. Curr Drug Saf 2015; 10 (02) 106-112
    CrossrefPubMedSearch in Google Scholar
  • 2 Clyman RI, Couto J, Murphy GM. Patent ductus arteriosus: are current neonatal treatment options better or worse than no treatment at all?. Semin Perinatol 2012; 36 (02) 123-129
    CrossrefPubMedSearch in Google Scholar
  • 3 Oncel MY, Erdeve O. Oral medications regarding their safety and efficacy in the management of patent ductus arteriosus. World J Clin Pediatr 2016; 5 (01) 75-81
    PubMedSearch in Google Scholar
  • 4 Erdeve O, Yurttutan S, Altug N. , et al. Oral versus intravenous ibuprofen for patent ductus arteriosus closure: a randomised controlled trial in extremely low birthweight infants. Arch Dis Child Fetal Neonatal Ed 2012; 97 (04) F279-F283
    CrossrefPubMedSearch in Google Scholar
  • 5 Erdeve O, Sarici SU, Sari E, Gok F. Oral-ibuprofen-induced acute renal failure in a preterm infant. Pediatr Nephrol 2008; 23 (09) 1565-1567
    CrossrefPubMedSearch in Google Scholar
  • 6 Hammerman C, Bin-Nun A, Markovitch E, Schimmel MS, Kaplan M, Fink D. Ductal closure with paracetamol: a surprising new approach to patent ductus arteriosus treatment. Pediatrics 2011; 128 (06) e1618-e1621
    CrossrefPubMedSearch in Google Scholar
  • 7 Oncel MY, Yurttutan S, Uras N. , et al. An alternative drug (paracetamol) in the management of patent ductus arteriosus in ibuprofen-resistant or contraindicated preterm infants. Arch Dis Child Fetal Neonatal Ed 2013; 98 (01) F94 . Doi: 10.1136/archdischild-2012-302044
    CrossrefPubMedSearch in Google Scholar
  • 8 Terrin G, Conte F, Oncel MY. , et al. Paracetamol for the treatment of patent ductus arteriosus in preterm neonates: a systematic review and meta-analysis. Arch Dis Child Fetal Neonatal Ed 2016; 101 (02) F127-F136
    CrossrefPubMedSearch in Google Scholar
  • 9 Yurttutan S, Oncel MY, Arayicı S. , et al. A different first-choice drug in the medical management of patent ductus arteriosus: oral paracetamol. J Matern Fetal Neonatal Med 2013; 26 (08) 825-827
    CrossrefPubMedSearch in Google Scholar
  • 10 Oncel MY, Yurttutan S, Erdeve O. , et al. Oral paracetamol versus oral ibuprofen in the management of patent ductus arteriosus in preterm infants: a randomized controlled trial. J Pediatr 2014; 164 (03) 510-514.e1
    CrossrefPubMedSearch in Google Scholar
  • 11 Oncel MY, Yurttutan S, Degirmencioglu H. , et al. Intravenous paracetamol treatment in the management of patent ductus arteriosus in extremely low birth weight infants. Neonatology 2013; 103 (03) 166-169
    CrossrefPubMedSearch in Google Scholar
  • 12 Ohlsson A, Shah PS. Paracetamol (acetaminophen) for patent ductus arteriosus in preterm or low-birth-weight infants. Cochrane Database Syst Rev 2015; 3 (03) CD010061 . Doi: 10.1002/14651858.CD010061.pub2
    PubMedSearch in Google Scholar
  • 13 Bayley N. Bayley Scales of Infant Development, 2nd ed. San Antonio, TX: Psychological Corporation; 1993
    Search in Google Scholar
  • 14 Eras Z, Gokmen T, Erdeve O, Ozyurt BM, Saridas B, Dilmen U. Impact of oral versus intravenous ibuprofen on neurodevelopmental outcome: a randomized controlled parallel study. Am J Perinatol 2013; 30 (10) 857-862
    Thieme ConnectPubMedSearch in Google Scholar
  • 15 Rheinlaender C, Helfenstein D, Pees C. , et al. Neurodevelopmental outcome after COX inhibitor treatment for patent ductus arteriosus. Early Hum Dev 2010; 86 (02) 87-92
    CrossrefPubMedSearch in Google Scholar
  • 16 Kabra NS, Schmidt B, Roberts RS, Doyle LW, Papile L, Fanaroff A. ; Trial of Indomethacin Prophylaxis in Preterms Investigators. Neurosensory impairment after surgical closure of patent ductus arteriosus in extremely low birth weight infants: results from the Trial of Indomethacin Prophylaxis in Preterms. J Pediatr 2007; 150 (03) 229-234 , 234.e1
    CrossrefPubMedSearch in Google Scholar
  • 17 Chorne N, Leonard C, Piecuch R, Clyman RI. Patent ductus arteriosus and its treatment as risk factors for neonatal and neurodevelopmental morbidity. Pediatrics 2007; 119 (06) 1165-1174
    CrossrefPubMedSearch in Google Scholar
  • 18 Weisz DE, More K, McNamara PJ, Shah PS. PDA ligation and health outcomes: a meta-analysis. Pediatrics 2014; 133 (04) e1024-e1046
    CrossrefPubMedSearch in Google Scholar
  • 19 Viberg H, Eriksson P, Gordh T, Fredriksson A. Paracetamol (acetaminophen) administration during neonatal brain development affects cognitive function and alters its analgesic and anxiolytic response in adult male mice. Toxicol Sci 2014; 138 (01) 139-147
    CrossrefPubMedSearch in Google Scholar
  • 20 Bauer AZ, Kriebel D. Prenatal and perinatal analgesic exposure and autism: an ecological link. Environ Health 2013; 12: 41 . Doi: 10.1186/1476-069X-12-41
    CrossrefPubMedSearch in Google Scholar