Comparison of Intravenous Versus Oral Paracetamol in Preterm Neonates With Patent Ductus Arteriosus

Objective: The aim of the study was to compare the efficacy of oral route versus intravenous paracetamol in promoting ductal closure in preterm neonates. Materials and Methods: This cross-sectional study was carried out in the Pediatrics Department of the Lady Reading Hospital, Peshawar. In case of unavailability of paracetamol, ibuprofen was kept as an alternative option ensuring continuity of care without compromising ethical or treatment standards. Baseline demographic details were recorded, and at the completion of treatment, the outcome in terms of PDA closure was noted. Data analysis was done using SPSS latest version, with the chi-square test applied for comparing efficacy of paracetamol between groups. Results: Oral paracetamol achieved higher PDA closure rates than intravenous therapy (80.5% vs. 67.5%). Closure was significantly greater in infants aged 32–34 weeks (p = 0.02) and in those with parents having secondary education (p = 0.03). A non-significant trend toward better outcomes was observed in females (p = 0.07), while socioeconomic status (p = 0.91) and neonatal weight (p = 0.88) had no effect. Conclusion: Oral paracetamol was more effective than intravenous paracetamol in promoting PDA closure in specific subgroups, particularly in neonates aged 32–34 weeks and those with parents having secondary education. This is essential as both educational and socioeconomic status are relevant as they can indirectly influence neonatal outcomes through factors such as timely access to treatment, antenatal care and availability of medications.