RTI uses cookies to offer you the best experience online. By clicking “accept” on this website, you opt in and you agree to the use of cookies. If you would like to know more about how RTI uses cookies and how to manage them please view our Privacy Policy here. You can “opt out” or change your mind by visiting: http://optout.aboutads.info/. Click “accept” to agree.
Patent ductus arteriosus, hydrocortisone, and outcome among infants born extremely preterm
Secondary analysis of the hydrocortisone trial
Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network (2025). Patent ductus arteriosus, hydrocortisone, and outcome among infants born extremely preterm: Secondary analysis of the hydrocortisone trial. The Journal of Pediatrics, 281, 114535. Article 114535. Advance online publication. https://doi.org/10.1016/j.jpeds.2025.114535
OBJECTIVE: To examine whether hydrocortisone (HC) modified the relationship of patent ductus arteriosus (PDA) to outcomes among infants born extremely preterm and enrolled in the NICHD Neonatal Research Network (NRN) HC trial.
STUDY DESIGN: This was a post hoc secondary analysis of infants born < 30 weeks' gestation and enrolled in the NRN HC Trial. The primary outcome was moderate to severe bronchopulmonary dysplasia (BPD) or death. Secondary outcomes included moderate to severe BPD, death, necrotizing enterocolitis (NEC), late-onset sepsis (LOS), days of mechanical ventilation, oxygen supplementation, Z-scores for growth, home oxygen, BPD severity, neurodevelopmental impairment (NDI) ,and moderate to severe cerebral palsy (CP). Analyses for interaction between PDA (defined as treatment to achieve PDA closure) and HC were performed for the primary and secondary outcomes.
RESULTS: Of 800 infants enrolled in the NRN HC trial, PDA was treated in 198 HC treated and 197 placebo-treated infants. HC did not modify the relationship of PDA with BPD or death (p=0.93). Regardless of HC treatment, PDA was associated with a significant increase in duration of ventilatory support, oxygen supplementation at 36 weeks postmenstrual age (PMA), BPD severity, decreased weight-for-age Z-score at 36 weeks PMA, moderate to severe BPD ,or death at 36 weeks PMA and home oxygen support.
CONCLUSIONS: HC after the second postnatal week did not alter the relationship between PDA and BPD or death among infants born extremely preterm. PDA was associated with several adverse outcomes regardless of HC treatment.
