Illustration of a premature infant in an incubator, symbolizing neonatal care and medical intervention.

PDA in Premature Babies: Understanding Treatment Options and Outcomes

Mira Elwood in Health & Wellness November 2025 • 4 min read.

"A comprehensive look at current strategies for managing Patent Ductus Arteriosus (PDA) in very-low-birth-weight infants in Korea, including treatment options and key considerations for parents and caregivers."

The failure of the ductus arteriosus to close after birth, known as Patent Ductus Arteriosus (PDA), is a common issue in premature infants, particularly those born very prematurely (less than 28 weeks of gestation). PDA can lead to increased mortality and other health problems, including bronchopulmonary dysplasia (BPD), periventricular hemorrhage, and necrotizing enterocolitis (NEC).

Deciding on the best course of treatment for PDA is complicated. There are potential risks associated with both medical treatments and surgical interventions. Therefore, clinicians must carefully consider the benefits and risks of each treatment when making management decisions.

Recent research and clinical trials have not reached a consensus on the best treatment strategies for PDA. This article explores current practices for managing PDA in very-low-birth-weight (VLBW) infants in Korea, based on data from the Korean Neonatal Network (KNN). We'll examine the various treatment approaches and factors influencing those decisions.

What are the Key Treatment Strategies for PDA in Premature Infants?

Illustration of a premature infant in an incubator, symbolizing neonatal care and medical intervention.

A study investigated current therapeutic strategies for PDA in very-low-birth-weight (VLBW) infants in Korea. The study included 2,254 VLBW infants from the Korean Neonatal Network cohort born between January 2013 and June 2014. Here's a breakdown of the findings:

Of the infants studied, approximately 46.5% were diagnosed with PDA and required treatment. The choice of treatment strategy depended on several factors, including the infant's gestational age and birthweight. The main treatment strategies observed were:

Prophylactic Treatment (PT): Administering treatment to prevent PDA, n = 69, 3.1%.
Pre-Symptomatic Treatment (PST): Treating PDA based on diagnostic findings before symptoms appear, n = 212, 9.4%.
Symptomatic Treatment (ST): Treating PDA in response to clinical signs and symptoms, n = 596, 26.4%.
Conservative Treatment (CT): Providing supportive care without medical or surgical intervention, n = 171, 7.6%.

Symptomatic treatment (ST) was the most common approach for preterm PDA. However, conservative treatment (CT) was favored over PST or ST in infants with a gestational age of 32 weeks or more.

What Does This Mean for Parents and Caregivers?

The management of PDA in premature infants is complex, with various treatment strategies available. The decision-making process depends on the baby's gestational age, birthweight, and clinical condition. Further research is needed to standardize treatment guidelines and improve outcomes for preterm infants with PDA.

About this Article -

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Everything You Need To Know

What exactly is Patent Ductus Arteriosus (PDA), and why is it a concern for premature babies?

Patent Ductus Arteriosus, or PDA, occurs when the ductus arteriosus, a blood vessel connecting the pulmonary artery to the aorta, fails to close after birth. This is particularly common in premature infants. The significance of PDA lies in its potential to cause increased mortality and other serious health issues like bronchopulmonary dysplasia (BPD), periventricular hemorrhage, and necrotizing enterocolitis (NEC). PDA can disrupt normal blood flow, placing stress on the infant's heart and lungs.

What are the different treatment strategies used for Patent Ductus Arteriosus (PDA) in premature infants?

The main treatment strategies are Prophylactic Treatment (PT), which aims to prevent PDA from occurring; Pre-Symptomatic Treatment (PST), which addresses PDA based on diagnostic findings before symptoms manifest; Symptomatic Treatment (ST), which involves treating PDA in response to clinical signs; and Conservative Treatment (CT), which focuses on supportive care without medical or surgical intervention. Each strategy has its place depending on the infant's condition, gestational age, and birthweight.

Which treatment approach is most commonly used for premature babies with Patent Ductus Arteriosus (PDA)?

Symptomatic Treatment (ST) was the most common approach for preterm PDA. This means clinicians often wait for clinical signs and symptoms of PDA to appear before initiating treatment. However, in infants with a gestational age of 32 weeks or more, Conservative Treatment (CT) was favored over Pre-Symptomatic Treatment (PST) or Symptomatic Treatment (ST). This suggests a more cautious approach is taken with older premature infants, potentially avoiding unnecessary interventions.

What factors do doctors consider when deciding on the best treatment for Patent Ductus Arteriosus (PDA)?

Several factors influence the choice of treatment. These include the infant's gestational age, birthweight, and overall clinical condition. Clinicians carefully weigh the potential benefits and risks of each treatment option, considering factors like the severity of PDA, the presence of other health complications, and the infant's response to initial supportive care. The decision-making process is complex and requires careful evaluation of individual circumstances.

Why is it important to have standardized treatment guidelines for Patent Ductus Arteriosus (PDA)?

Standardizing treatment guidelines for PDA is crucial because it can lead to more consistent and effective care across different healthcare settings. Given the varying treatment strategies and the lack of consensus in research, standardized guidelines could help reduce variability in practice and ensure that all preterm infants with PDA receive the most appropriate and evidence-based treatment, ultimately improving outcomes and reducing the risk of complications.