Introduction and objective: Patent ductus arteriosus is a heart defect primarily associated with extreme prematurity. It can lead to multiple morbidities due to diminished organ perfusion or a left-to-right shunt. It can be treated with paracetamol, among other options. Treatment includes fluid restriction, pharmacotherapy (paracetamol at a dose of 15 mg/kg, non-steroidal anti-inflammatory drugs), percutaneous interventions, and surgical ligation. This retrospective study aims to analyse whether the analgesic dose of paracetamol and artificial ventilation has any effect on the occurrence of ductus arteriosus. Materials and methods: Ninety-four prematurely born neonates (<32 weeks of gestation) between 2020 and 2023 were included in the study. The dose of paracetamol, surfactant supply, and steroid therapy in the prenatal period were analysed up to the first echocardiographic examination. Additionally, data were collected about the type of ventilation during the examination. Logistic regression was used to evaluate predictive factors for PDA presence. Results: The median gestational age and weight were 30 weeks and 1290 g, respectively. Among 49 preterm neonates treated with intravenous paracetamol at an analgesic dose of ≤10 mg/kg, the risk of ductus arteriosus patency was lower (p = 0.002). Both non-invasive and mechanical ventilation increased the risk of ductus patency (p = 0.042, p = 0.044). There was no significant relationship between previous ductus and surfactant treatment or prenatal steroid use (p = 0.611, p = 0.93). Conclusions: Paracetamol in an analgesic dose reduces the likelihood of open ductus arteriosus in extremely and very premature infants. Additionally, artificial ventilation is a significant factor affecting ductus patency.

Background: An optimal 25OHD level can prevent osteopenia of prematurity (bone health) and premature delivery (non-skeletal activity). Although maternal and fetal vitamin D (25OHD) levels correlate, data on preterm infants’ 25OHD status at birth are limited, with a well-recognized deficiency among term infants. Objectives: To evaluate maternal and neonatal 25OHD status at preterm birth and its determinants in a northern-latitude country, Poland. Design/Methods: Cross-sectional study between August 2015 and September 2016 investigating cord and maternal blood 25OHD levels at delivery in 69 pairs of mothers and newborns ≤ 32 6/7 weeks of gestation, and analyzing correlations between maternal and neonatal 25OHD levels and their influencing factors, with univariable and multivariable linear regression. Results: Median (IQR) 25OHD levels were 25 (16.6–34 ng/mL) in cord blood and 21.2 (15–29 ng/mL) in mothers and correlated positively (r = 0.69, p < 0.0001). 25OHD insufficiency was detected in 84.06% of mothers and 62.32% of newborns. Maternal 25OHD levels were higher in summertime delivery (p = 0.0008). The rate of vitamin D supplementation during pregnancy was 54.4%, increasing maternal (27 ng/mL vs. 16.7 ng/mL, p = 0.0006), cord blood (32.4 ng/mL vs. 17.4 ng/mL, p = 0.0005), and summer seasonal cord blood 25OHD levels (38.89 ng/mL vs. 25.5 ng/mL, p = 0.023), and the percentage of maternal (72.7% vs. 27.3%, p = 0.005) and neonatal 25OHD sufficiency (80% vs. 20%, p = 0.0021). Conclusions: Vitamin D insufficiency is common in mothers and their prematurely born infants at birth; vitamin D supplementation reverses the trend. To avoid inadequate supplementation in preterm newborns and in mothers at risk of preterm delivery, regular assessment of 25OHD levels should be considered.