In the neonatal intensive care unit at Oulu University Hospital, researchers have found that a simple, common painkiller may help save the tiniest lives. Paracetamol, given intravenously to extremely preterm infants, dramatically accelerates the closure of patent ductus arteriosus (PDA)—a condition where a fetal blood vessel fails to close after birth—reducing the median closure time from 14 days to just three days.
Patent ductus arteriosus occurs when the ductus arteriosus, the blood vessel that normally diverts blood away from fetal lungs, fails to close normally after birth. This matters because in the smallest preterm infants—those born before 28 weeks of gestation or weighing less than one kilogram—an open PDA can increase the risk of serious complications and even death. For these fragile newborns, any intervention that speeds healing without introducing new harm represents genuine hope.
A joint study by the University of Oulu and Oulu University Hospital, published in the journal Neonatology, enrolled 40 of these extremely preterm infants in a randomized, double-blind trial. Half received intravenous paracetamol while the other half received placebo. The medication was started shortly after birth with a loading dose, then given every six hours for nine days. Doctors monitored the infants' ductus arteriosus daily using echocardiography, watching for the moment of closure.
The results were striking. Among infants who received paracetamol, 75 percent experienced complete closure of the ductus arteriosus during the study period, compared with only 35 percent in the placebo group. More dramatically, the treatment reduced the median time to closure from 14 days to three days—a fourfold acceleration. Three infants in the placebo group ultimately required additional PDA treatment after the study concluded, while the paracetamol group showed no need for escalation. Importantly, researchers found no difference in adverse events between the two groups, suggesting the treatment was as safe as it was effective.
The study team emphasized that this remains an early-stage pilot, and while the results are encouraging, they are calling for larger clinical trials before paracetamol prophylaxis can be adopted into standard neonatal care guidelines. This cautious optimism reflects the careful work of medicine: promising findings must be validated at scale before transforming practice. Yet for families facing the precarious first days of their tiniest infants' lives, the prospect of a drug already used safely in billions of doses worldwide offering a faster path to closure represents a meaningful step forward. The researchers' work opens a pathway toward gentler, simpler care for the most vulnerable newborns—care that harnesses what is already known to prevent complications before they take hold.