Background: Patent ductus arteriosus (PDA) is a common factor complicating the care of the preterm infant,
but controversy remains regarding the long term effects of PDA and iatrogenic closure of PDA.
Methods: Studies presenting data relevant to the relationship between PDA and mortality and morbidity were identified
via a systematic literature review. These studies were classified based on PDA exposure in the case and control groups.
The data was abstracted and summarized using linear modeling, resulting in summary estimates of mean effect size (odds
Results: Recently published data suggests that a significant relationship between PDA and mortality, bronchopulmonary
dysplasia/chronic lung disease, necrotizing enterocolitis, or retinopathy of prematurity is unlikely. However, the data related
to mortality leaves room for some debate. Quantitative analysis of the data shows that PDA is a risk factor for intraventricular
hemorrhage and related studies suggest this risk may carry over into long term neurological outcomes.
Conclusion: Further efforts to better understand the physiologic consequences of PDA and its closure in preterm infants is
necessary. A focus on new biochemical or physiologic factors that mediate or confound any apparent effect of PDA and
are themselves amenable to targeted therapy is imperative to further progress in improving the outcomes of these patients.