Efficacy of ibuprofen versus acetaminophen and conservative management for closure of patent ductus arteriosus in preterm neonates: a randomized clinical trial

PDA status after treatment	Statistics	Intervention		Total	χ²	p
PDA status after treatment	Statistics	Acetaminophen	Ibuprofen	Total	χ²	p
Closed	n	97	103	200	2.18	0.14
Closed	%	89.00%	94.50%	91.70%
Open	n	12	6	18
Open	%	11.00%	5.50%	8.30%
		Acetaminophen	Control
Closed	n	97	78	175	10.46	< 0.001
Closed	%	89.00%	71%	80.3%
Open	n	12	31	43
Open	%	11.00%	29%	19.7%
		Ibuprofen	Control
Closed	n	103	78	181	26.35	< 0.001
Closed	%	94.50%	71%	83%
Open	n	6	31	37
Open	%	5.50%	29%	17%

Pre-treatment demographic and echocardiographic characteristics of neonates in the three study groups_

Variable	Acetaminophen Mean ± SD	Ibuprofen Mean ± SD	Control Mean ± SD	Total Mean ± SD	25th	50th (Median)	75th	χ²	P-value
Gestational age (weeks)	32.06 ± 2.45	31.63 ± 2.66	31.61 ± 2.56	31.77 ± 2.56	29.00	32.000	34.00	2.293	0.318
Birth weight (g)	1816.06 ± 448.78	1739.31 ± 441.30	1815.82 ± 427.25	1790.39 ± 439.34	1426.00	1774.00	2136.00	2.014	0.365
LA/Ao before treatment	1.49 ± 0.01	1.49 ± 0.01	1.49 ± 0.01	1.49 ± 0.01	1.48	1.4891	1.50	0.948	0.389
PDA diameter before treatment (mm)	2.35 ± 0.30	2.34 ± 0.33	2.34 ± 0.32	2.35 ± 0.31	2.10	2.3517	2.50	0.019	0.981

Effect of gestational age on PDA closure: pairwise comparisons between acetaminophen, ibuprofen, and control groups_

Gestational age (GA)	PDA status after treatment	Statistics	Intervention		Total	χ²	p
Gestational age (GA)	PDA status after treatment	Statistics	Acetaminophen	Ibuprofen	Total	χ²	p
GA < 32 weeks	Closed	n	52	57	109	0.442	0.51
	Closed	%	86.70	90.50	88.60
	Open	n	8	6	14
	Open	%	13.30	9.50	11.40
GA ≥ 32 weeks	Closed	n	45	46	91	3.92	0.05
	Closed	%	91.80	100.00	95.80
	Open	n	4	0	4
	Open	%	8.20	0.00	4.20
			Acetaminophen	Control
GA < 32 weeks	Closed	n	52	50	102	4.44	0.035
	Closed	%	86.7%	71.4%	78.5%
	Open	n	8	20	28
	Open	%	13.3%	28.6%	21.5%
GA ≥ 32 weeks	Closed	n	45	28	73	6.17	0.013
	Closed	%	91.8%	71.8%	83.0%
	Open	n	4	11	15
	Open	%	8.2%	28.2%	17.0%
			Ibuprofen	Control
GA < 32 weeks	Closed	n	57	50	107	7.65	0.006
	Closed	%	90.5%	71.4%	80.5%
	Open	n	6	20	26
	Open	%	9.5%	28.6%	19.5%
GA ≥ 32 weeks	Closed	n	46	28	74	14.90	< 0.001
	Closed	%	100.0%	71.8%	87.1%
	Open	n	0	11	11
	Open	%	0.0%	28.2%	12.9%

Effect of birth weight on PDA closure: pairwise comparisons between acetaminophen, ibuprofen, and control groups_

Weight at birth	PDA status after treatment	Statistics	Intervention		Total	χ²	p
Weight at birth	PDA status after treatment	Statistics	Acetaminophen	Ibuprofen	Total	χ²	p
Weight at birth < 1500 g	Closed	n	25	30	55	0.07	0.79
	Closed	%	83.30	85.70	84.60
	Open	n	5	5	10
	Open	%	16.70	14.30	15.40
Weight at birth > = 1500 g	Closed	n	72	73	145	4.348	0.04
	Closed	%	91.10	98.60	94.80
	Open	n	7	1	8
	Open	%	8.90	1.40	5.20
			Acetaminophen	Control
Weight at birth < 1500 g	Closed	n	25	23	48	0.760	0.384
	Closed	%	83.3%	74.2%	78.7%
	Open	n	5	8	13
	Open	%	16.7%	25.8%	21.3%
Weight at birth > = 1500 g	Closed	n	72	55	127	10.803	<0.001
	Closed	%	91.1%	70.5%	80.9%
	Open	n	7	23	30
	Open	%	8.9%	29.5%	19.1%
			Ibuprofen	Control
Weight at birth < 1500 g	Closed	n	30	23	53	1.380	0.240
	Closed	%	85.7%	74.2%	80.3%
	Open	n	5	8	13
	Open	%	14.3%	25.8%	19.7%
Weight at birth > = 1500g	Closed	n	73	55	128	22.608	<0.001
	Closed	%	98.6%	70.5%	84.2%
	Open	n	1	23	24
	Open	%	1.4%	29.5%	15.8%

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DOI: https://doi.org/10.2478/rjc-2026-0012 | Journal eISSN: 2734-6382 | Journal ISSN: 1220-658X

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Language: English

Published on: May 29, 2026

Published by: Romanian Society of Cardiology

In partnership with: Paradigm Publishing Services

Publication frequency: 4 issues per year

Keywords:

Acetaminophen,

Ibuprofen,

Patent ductus arteriosus,

Preterm neonates,

Randomized clinical trial

Related subjects:

Surgery,

Pediatrics and juvenile medicine,

Paediatric cardiology

© 2026 Noor Mohammad Noori, Alireza Teimouri, Saeedeh Yaghoubi, published by Romanian Society of Cardiology
This work is licensed under the Creative Commons Attribution 4.0 License.

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Efficacy of ibuprofen versus acetaminophen and conservative management for closure of patent ductus arteriosus in preterm neonates: a randomized clinical trial

Figures & Tables

Figure 1

Pairwise analysis of post-treatment PDA closure between acetaminophen, ibuprofen, and control groups_

Pre-treatment demographic and echocardiographic characteristics of neonates in the three study groups_

Effect of gestational age on PDA closure: pairwise comparisons between acetaminophen, ibuprofen, and control groups_

Effect of birth weight on PDA closure: pairwise comparisons between acetaminophen, ibuprofen, and control groups_

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