Comparison of the Efficacy and Complications of Oral versus Intravenous Ibuprofen in Low-birth-weight Neonates with Patent Ductus Arteriosus: A Retrospective Cohort Study

Background: Patent ductus arteriosus (PDA) is associated with morbidity in preterm neonates. This study aimed to compare the efficacy of oral versus intravenous Ibuprofen in preterm neonates with PDA.Methods: 80 low birth weight neonates (gestational age <37 weeks) with PDA were enrolled in this retrospective cohort study. Both groups received an equal dose of 10mg/kg followed by 5 mg/kg for 2 days. In the first group, ibuprofen was administered intravenously and in the second group, it was administered via the oral route. PDA was initially confirmed by echocardiography.Results: Gestational age in the two groups ranged from 29 to 36 weeks. PDA remained open in 3 patients in the IV group (7.5%) and 1 patient in the oral ibuprofen group (2.5%). Although complications' were on average lower in neonates treated with IV ibuprofen, this difference was not significant. Similarly, the PDA closure rate did not differ significantly between the groups. However, in the oral group, the PDA closure rate was 39 (97.5%) after the third treatment course (95% CI: 86.8%-99.9%) while in the IV group, the PDA closure rate was 37(92.5%, 95% CI: 79.6%- 98.4%). Compared to infants treated with intravenous ibuprofen, the rate ratio and rate difference of PDA closure were estimated at 0.94 (95% CI: 0.85, 1.04) and-0.05 (95% CI:-0.14, 0.04), in orally treated patients, respectively.Conclusion: This study suggested that oral ibuprofen is as effective as intravenous ibuprofen for the management of PDA in pregnant women with gestational age <37 weeks. In fact, oral ibuprofen is an alternative to intravenous ibuprofen with lower side effects for the treatment of preterm neonates with PDA.