CLINICAL TRIAL published: 31 July 2020 doi: 10.3389/fped.2020.00434 Frontiers in Pediatrics | www.frontiersin.org 1 July 2020 | Volume 8 | Article 434 Edited by: Vineet Bhandari, Cooper University Hospital, United States Reviewed by: Jonathan Slaughter, Nationwide Children’s Hospital, United States Erik Allen Jensen, Children’s Hospital of Philadelphia, United States *Correspondence: Omer Erdeve omererdeve@yahoo.com Specialty section: This article was submitted to Neonatology, a section of the journal Frontiers in Pediatrics Received: 02 April 2020 Accepted: 22 June 2020 Published: 31 July 2020 Citation: Okulu E, Erdeve O, Arslan Z, Demirel N, Kaya H, Gokce IK, Ertugrul S, Cetinkaya M, Buyukkale G, Ozlu F, Simsek H, Celik Y, Ozkan H, Köksal N, Akcan B, Turkmen M, Celik K, Armangil D, Bulbul A, Tekgunduz KS, Oncel MY, Tuzun F, Ergenekon E, Ergin H, Arsan S and Turkish Neonatal Society INTERPDA Study Group (2020) An Observational, Prospective, Multicenter, Registry-Based Cohort Study Comparing Conservative and Medical Management for Patent Ductus Arteriosus. Front. Pediatr. 8:434. doi: 10.3389/fped.2020.00434 An Observational, Prospective, Multicenter, Registry-Based Cohort Study Comparing Conservative and Medical Management for Patent Ductus Arteriosus Emel Okulu 1 , Omer Erdeve 1 *, Zehra Arslan 2 , Nihal Demirel 3 , Huseyin Kaya 4 , Ismail Kursad Gokce 4 , Sabahattin Ertugrul 5 , Merih Cetinkaya 6 , Gokhan Buyukkale 6 , Ferda Ozlu 7 , Huseyin Simsek 7 , Yalcin Celik 8 , Hilal Ozkan 9 , Nilgun Köksal 9 , Baris Akcan 10 , Munevver Turkmen 10 , Kiymet Celik 11 , Didem Armangil 12 , Ali Bulbul 13 , Kadir Serafettin Tekgunduz 14 , Mehmet Yekta Oncel 15 , Funda Tuzun 16 , Ebru Ergenekon 17 , Hacer Ergin 18 , Saadet Arsan 1 and Turkish Neonatal Society INTERPDA Study Group 1 Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey, 2 Department of Neonatology, Etlik Zubeyde Hanim Women’s Health Teaching and Research Hospital, University of Health Sciences, Ankara, Turkey, 3 Division of Neonatology, Department of Pediatrics, Ankara Yildirim Beyazit University School of Medicine, Ankara, Turkey, 4 Division of Neonatology, Department of Pediatrics, Inonu University School of Medicine, Malatya, Turkey, 5 Division of Neonatology, Department of Pediatrics, Dicle University School of Medicine, Diyarbakir, Turkey, 6 Department of Neonatology, University of Health Sciences, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey, 7 Division of Neonatology, Department of Pediatrics, Cukurova University School of Medicine, Adana, Turkey, 8 Division of Neonatology, Department of Pediatrics, Mersin University School of Medicine, Mersin, Turkey, 9 Division of Neonatology, Department of Pediatrics, Uludag University School of Medicine, Bursa, Turkey, 10 Division of Neonatology, Department of Pediatrics, Adnan Menderes University School of Medicine, Aydin, Turkey, 11 Neonatal Intensive Care Unit, Diyarbakir Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey, 12 Neonatal Intensive Care Unit, Koru Hospital, Ankara, Turkey, 13 Department of Neonatology, University of Health Sciences, Sisli Etfal Hamidiye Training and Research Hospital, Istanbul, Turkey, 14 Division of Neonatology, Department of Pediatrics, Ataturk University School of Medicine, Erzurum, Turkey, 15 Division of Neonatology, Department of Pediatrics, Izmir Katip Celebi University School of Medicine, Izmir, Turkey, 16 Division of Neonatology, Department of Pediatrics, Dokuz Eylul University School of Medicine, Izmir, Turkey, 17 Division of Neonatology, Department of Pediatrics, Gazi University School of Medicine, Ankara, Turkey, 18 Division of Neonatology, Department of Pediatrics, Pamukkale University School of Medicine, Denizli, Turkey No consensus has been reached on which patent ductus arteriosus (PDAs) in preterm infants require treatment and if so, how, and when they should be treated. A prospective, multicenter, cohort study was conducted to compare the effects of conservative approaches and medical treatment options on ductal closure at discharge, surgical ligation, prematurity-related morbidities, and mortality. Infants between 24 0/7 and 28 6/7 weeks of gestation from 24 neonatal intensive care units were enrolled. Data on PDA management and patients’ clinical characteristics were recorded prospectively. Patients with moderate-to-large PDA were compared. Among the 1,193 enrolled infants (26.7 ± 1.4 weeks and 926 ± 243 g), 649 (54%) had no or small PDA, whereas 544 (46%) had moderate-to-large PDA. One hundred thirty (24%) infants with moderate-to-large PDA were managed conservatively, in contrast to 414 (76%) who received medical treatment. Eighty (62%) of 130 infants who were managed conservatively did not receive any rescue treatment and the PDA closure rate was 53% at discharge. There were no