Prophylactic low‐dose paracetamol for ductal closure and neurodevelopmental outcome in very preterm infants

Abstract

Aim:To investigate the direct effect of prophylactic low-dose paracetamol administration for ductal closure on neurodevelopmental outcome in very preterm infants who did not receive ibuprofen or surgical ligation for treatment of a patent ductus arteriosus. Methods: Infants < 32 gestational weeks born 10/2014-12/2018 received prophylactic paracetamol (paracetamol group, n = 216); infants born 02/2011-09/2014 did not receive prophylactic paracetamol (control group, n = 129). Psychomotor (PDI) and mental (MDI) outcome were assessed using Bayley Scales of Infant Development at 12 and 24 months corrected age.Results: Our analyses showed significant differences in PDI and MDI at age 12 months (B = 7.8 (95% CI 3.90-11.63), p < 0.001 and B = 4.2 (95% CI 0.81-7.63), p = 0.016). At age 12 months, the rate of psychomotor delay was lower in the paracetamol group (OR 2.22, 95% CI 1.28-3.94, p = 0.004). There was no significant difference between the rates of mental delay at any time-point. All group differences remained significant after adjustment for potential confounders p < 0.001,, p = 0.013, PDI < 85 12 months OR 2.65 (95% CI 1.44-4.87), p = 0.002). Conclusion:We found no impairment of psychomotor and mental outcome at age 12 and 24 months in very preterm infants after prophylactic low-dose paracetamol administration.

Relationship between Brain Function and Microstructural Brain Maturation in Preterm Infants

“…The Bayley-II assesses psychomotor (PDI) and mental (MDI) developmental indices, the Bayley-III evaluates motor, cognitive, and language scales. We used the mean between the cognitive and language scale of the Bayley-III and equalized it with the former MDI of the Bayley-II as applied before [12]. A delayed outcome was defined as score <85.…”