(COLUMBUS, Ohio) – In a study alongside researchers from the NICHD Neonatal Research Network and lead investigator Matthew Laughon, MD, MPH, at UNC Health and the UNC School of Medicine, researchers from Nationwide Children’s Hospital have found that a “watchful waiting” approach rather than medication treatment for a common diagnosis in premature infants could be better disease management and potentially save lives.
The study, published today in JAMA, found that preterm infants with patent ductus arteriosus (PDA) who were treated at ≤21 days of age with nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen showed no improvement in outcomes, and were twice as likely to die, with increased deaths from infections. According to the study, for every 18 infants treated with expectant management instead of active medication treatment, one more infant survived.
“Physicians have been treating PDA with NSAIDs since at least 1976, and the findings of this study starkly upend the medical understanding of the last 50 years,” said Jonathan Slaughter, MD, MPH, co-author of the study, neonatologist and principal investigator in the Center for Perinatal Research at Nationwide Children’s. “We need more research regarding treatment for the sickest preterm infants with PDA, but we now know that routine use of these medications to treat most infants with PDA is no longer indicated.”
PDA is commonly diagnosed in preterm infants, in which a fetal blood vessel that connects the aorta to the pulmonary artery remains open after birth. PDA in preterm infants has been associated with complications of prematurity including bronchopulmonary dysplasia (BPD). Historically, PDA in preterm infants has been treated with either NSAIDs or surgery to close the ductus arteriosus.
“Because PDA can close on its own, a watchful waiting approach can be beneficial to these patients who are already more fragile than term infants,” said Pablo Sanchez, MD, co-author of the study, pediatric neonatologist and infectious diseases specialist at Nationwide Children’s. “It’s important that providers and families work together to continue advancing optimal care for this condition.”
About The Abigail Wexner Research Institute at Nationwide Children's Hospital
Named to the Top 10 Honor Roll on U.S. News & World Report’s 2025-26 list of “Best Children’s Hospitals,” Nationwide Children’s Hospital is one of America’s largest not-for-profit free-standing pediatric health care systems providing unique expertise in pediatric population health, behavioral health, genomics and health equity as the next frontiers in pediatric medicine, leading to best outcomes for the health of the whole child. Integrated clinical and research programs are part of what allows Nationwide Children’s to advance its unique model of care. As home to the Department of Pediatrics of The Ohio State University College of Medicine, Nationwide Children’s faculty train the next generation of pediatricians, scientists and pediatric specialists. The Abigail Wexner Research Institute at Nationwide Children’s Hospital is one of the Top 10 National Institutes of Health-funded free-standing pediatric research facilities in the U.S., supporting basic, clinical, translational, behavioral and population health research. The AWRI is comprised of multidisciplinary Centers of Emphasis paired with advanced infrastructure supporting capabilities such as technology commercialization for discoveries; gene- and cell-based therapies; and genome sequencing and analysis. More information is available at NationwideChildrens.org/Research