Effect modification of late surfactant treatment by patent ductus arteriosus status in ventilated preterm infants: a secondary analysis of a randomized clinical trial

Patrick J Peebles; Jens C Eickhoff; Timothy G Elgin; Anudeepa Sharma; Nicolas A Bamat; Jonathan M Klein; Patrick J McNamara; Roberta L Keller; Dinushan C Kaluarachchi

doi:10.1038/s41372-026-02705-x

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Effect modification of late surfactant treatment by patent ductus arteriosus status in ventilated preterm infants: a secondary analysis of a randomized clinical trial

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Effect modification of late surfactant treatment by patent ductus arteriosus status in ventilated preterm infants: a secondary analysis of a randomized clinical trial

Patrick J Peebles, Jens C Eickhoff, Timothy G Elgin, Anudeepa Sharma, Nicolas A Bamat, Jonathan M Klein, Patrick J McNamara, Roberta L Keller and Dinushan C Kaluarachchi

Journal of perinatology

04/20/2026

DOI: 10.1038/s41372-026-02705-x

PMID: 42009897

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Abstract

To evaluate whether the effect of late surfactant is modified by patent ductus arteriosus (PDA) status with respect to survival without bronchopulmonary dysplasia (BPD) in ventilated infants born <28 weeks' gestation. Secondary analysis of the Trial of Late Surfactant (TOLSURF). A formal test of interaction between PDA presence and late surfactant, with respect to survival without BPD at 36 and 40 weeks' postmenstrual age (PMA), was performed. PDA presence was defined by PDA treatment, either medical or a ligation (definition A), or PDA ligation (definition B), during or after late surfactant administration. All 511 infants were included. No interaction was detected between a PDA and late surfactant for survival without BPD at 36 weeks' PMA (definition A: p = 0.41; definition B: p = 0.33), or at 40 weeks' PMA (definition A: p = 0.84; definition B: p = 0.42). PDA presence did not modify the effect of late surfactant for survival without BPD.

Details

Title: Subtitle: Effect modification of late surfactant treatment by patent ductus arteriosus status in ventilated preterm infants: a secondary analysis of a randomized clinical trial
Creators: Patrick J Peebles - University of Wisconsin–Madison
Jens C Eickhoff - University of Wisconsin–Madison
Timothy G Elgin - University of Wisconsin–Madison
Anudeepa Sharma - University of Wisconsin–Madison
Nicolas A Bamat - Children's Hospital of Philadelphia
Jonathan M Klein - University of Iowa Hospitals and Clinics
Patrick J McNamara - University of Iowa Hospitals and Clinics
Roberta L Keller - University of California, San Francisco
Dinushan C Kaluarachchi - University of Wisconsin–Madison
Resource Type: Journal article
Publication Details: Journal of perinatology
DOI: 10.1038/s41372-026-02705-x
PMID: 42009897
ISSN: 1476-5543
eISSN: 1476-5543
Publisher: Springer Nature
Language: English
Electronic publication date: 04/20/2026
Academic Unit: Stead Family Department of Pediatrics; Neonatology
Record Identifier: 9985155513802771

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