The Effect of Oral Acetaminophen on Open Arterial Duct Closure in Premature Infants Less Than 32 Weeks

Abstract

Abstract Background In most term neonates, the ductus arteriosus closes functionally on the first day of life, and a permanently open ductus arteriosus is abnormal. Objectives To evaluate the effect of oral acetaminophen on patent arterial duct (PDA) closure in premature infants less than 32 weeks. Methods This randomized clinical trial was performed on 140 preterm neonates with gestational age less than 32 weeks and birth weight less than 1,500 g, admitted to the neonatal intensive care unit of Ali Enbe Abitalib Hospital in Zahedan between 2019 and 2021. The neonates were randomly divided into two groups, with and without acetaminophen administration. In the intervention group, acetaminophen drops were started during the first 24 hours after birth and were administered for five days. In both groups, echocardiography was performed five days after birth. Finally, the data were analyzed in SPSS software. Results About 140 neonates with gestational age of ≤32 weeks and weight at birth ≤1,500 g were admitted for the study. The neonates were equally divided into two groups and acetaminophen medication assigned for one of the groups. Of the 70 neonates who did not receive acetaminophen administration, 75.7% had PDA closure spontaneously; this pattern was 94.3% in patients who had treatment with acetaminophen. This effect of treatment was significant (X2=9.468, p=0.002). Conclusion The study showed significant improvement in PDA in neonates receiving paracetamol. This can have a significant impact on the treatment approach to preterm neonates.