ReviewJournal of perinatology : official journal of the California Perinatal Association2023
Acetaminophen for the patent ductus arteriosus: has safety been adequately demonstrated?
Review in Journal of perinatology : official journal of the California Perinatal Association, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 15 citations in OpenAlex.
- Urinary Acetaminophen Metabolites and Clinical Outcomes in Extremely Premature Infants.American journal of perinatology · 2025Pooled it
- Beneficial vs harmful effects of pharmacological treatment of patent ductus arteriosus: A Bayesian meta-analysis.Pediatric research · 2025Pooled it
- [Expectant management versus acetaminophen for early treatment of hemodynamically significant patent ductus arteriosus in very preterm infants: a randomized controlled trial].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2026Trial
- Does use of acetaminophen and/or NSAIDs increase the risk of developing bronchopulmonary dysplasia?Pediatric research · 2026Article
- Paracetamol as analgesic and risk of bronchopulmonary dysplasia in extremely preterm infants: a secondary analysis of the BeNeDuctus trial.Pediatric research · 2026Article
- TLR9-mediated innate immune signaling contributes to acetaminophen-induced injury in the developing lung.American journal of physiology. Lung cellular and molecular physiology · 2026Article
- PDA in Prematurity: Rethinking a Decades-Old Debate in 2026.Biomedicines · 2026Review
- Management of patent ductus arteriosus in preterm neonates ≤32 weeks: a national survey of physician practices in Indian NICUs.Frontiers in pediatrics · 2026Article
- Management of the patent ductus arteriosus among infants born at 23 to 32 weeks' gestation between 2011 to 2022: a report from in the Children's Hospitals Neonatal Consortium.Journal of perinatology : official journal of the California Perinatal Association · 2025Article
- A Single Early-Life Acetaminophen Exposure Causes Persistent Abnormalities in the Murine Lung.American journal of respiratory cell and molecular biology · 2025Article
- Trends in bronchopulmonary dysplasia and 15-year evolution in respiratory and hemodynamic management of very premature infants.Scientific reports · 2025Observational
- Response of the ductus arteriosus to acetaminophen or indomethacin in extremely low birth weight infants.Journal of perinatology : official journal of the California Perinatal Association · 2025Article
- Acetaminophen for Patent Ductus Arteriosus and Risk of Mortality and Pulmonary Morbidity.Pediatrics · 2024Article
- Secular Trends in Patent Ductus Arteriosus Management in Infants Born Preterm in the National Institute of Child Health and Human Development Neonatal Research Network.The Journal of pediatrics · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 4 institutions in 2 countries.
Funding
Abstract
Patent ductus arteriosus (PDA) is the most common cardiovascular condition diagnosed in premature infants. Acetaminophen was first proposed as a potential treatment for PDA in 2011. Since that time acetaminophen use among extremely preterm neonates has increased substantially. The limited available data demonstrate that acetaminophen reduces PDA without evident hepatotoxicity. These findings have led some to suggest that acetaminophen is a safe and effective therapy for PDA closure. However, the lack of apparent hepatoxicity is predictable. Acetaminophen induced cellular injury is due to CYP2E1 derived metabolites; and hepatocyte CYP2E1 expression is low in the fetal and neonatal period. Here, we review preclinical and clinical data that support the hypothesis that the lung, which expresses high levels of CYP2E1 during fetal and early postnatal development, may be particularly susceptible to acetaminophen induced toxicity. Despite these emerging data, the true potential pulmonary risks and benefits of acetaminophen for PDA closure are largely unknown. The available clinical studies in are marked by significant weakness including low sample sizes and minimal evaluation of extremely preterm infants who are typically at highest risk of pulmonary morbidity. We propose that studies interrogating mechanisms linking developmentally regulated, cell-specific CYP2E1 expression and acetaminophen-induced toxicity as well as robust assessment of pulmonary outcomes in large trials that evaluate the safety and efficacy of acetaminophen in extremely preterm infants are needed.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.