Mortality and clinical outcomes in preterm infants with patent ductus arteriosus according to pharmacological treatment or expectant management: a retrospective cohort study

Introduction Patent ductus arteriosus (PDA) is frequent in preterm newborns and its management remains controversial. The objective was to evaluate the association between pharmacological treatment of PDA and mortality in preterm infants. Methods Retrospective cohort study. A sample size of 154 patients was estimated. Comparisons were performed using the Chi-square test for qualitative variables, and the Mann–Whitney test for continuous variables. Survival analysis was performed using the Kaplan–Meier curve and log-rank test. Cox regression models were used to estimate Hazard ratios (HR) with 95% confidence intervals (95% CI). Results A total of 156 patients were included. In the survival analysis, Kaplan–Meier curves showed a lower probability of survival in the treated group. In the Cox proportional hazards model, pharmacological treatment was not independently associated with mortality (HR: 2.25; 95% CI: 0.86–5.88; p = 0.09). Birth weight was independently associated with a lower mortality hazard rate (HR: 0.997; 95% CI: 0.995–0.999; p = 0.020). No significant associations were observed with sepsis. Conclusion Expectant management was not associated with an increase in morbidity or mortality. The lower survival observed with pharmacological treatment in the unadjusted analyses was not maintained after adjustment.