{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T08:07:57Z","timestamp":1784534877836,"version":"3.55.0"},"reference-count":12,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Perinatol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Management of hemodynamically significant patent ductus arteriosus (hsPDA) in neonates remains controversial, with wide variation in practice among neonatologists and pediatric cardiologists.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An IRB-approved anonymous 12-item survey assessing hsPDA screening, treatment preferences, and perceived risks and benefits was distributed to over 5,000 U.S. providers. Responses were statistically analyzed using standard parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 462 completed surveys were analyzed (35% cardiologists, 64% neonatologists). Most providers-initiated PDA screening based on clinical condition. Medical therapy was the preferred first-line treatment. Nearly one-third favored conservative management when echocardiographic hsPDA was present with minimal clinical concern, while others delayed intervention beyond the neonatal period. Pediatric cardiologists were more likely than neonatologists to believe PDA closure reduces morbidity and mortality, although most providers still elected to treat hsPDA. Neonatologists favored medical and percutaneous approaches over surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Significant inter-specialty variation persists in hsPDA management, highlighting the need for standardized, clinically integrated approaches.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s41372-026-02798-4","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T07:49:19Z","timestamp":1784533759000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Universal practice based management of patent ductus arteriosus in premature neonates in 2025: BRONX PDA protocol and BRONX clinical scoring system (BCSS)"],"prefix":"10.1038","author":[{"given":"Priscila","family":"Lisboa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinal","family":"Gada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonia","family":"Gaudig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adithya","family":"Sivakumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8066-942X","authenticated-orcid":false,"given":"Shantanu","family":"Rastogi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena N.","family":"Kwon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Fazzari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Sutton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5511-6348","authenticated-orcid":false,"given":"Manoj","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"key":"2798_CR1","doi-asserted-by":"crossref","unstructured":"Ambalavanan N, Aucott SW, Salavitabar A, Levy VYCommittee on Fetus and Newborn, Section on Cardiology and Cardiac Surgery Patent ductus arteriosus in preterm infants. Pediatrics. 2025;155:e2025071425.","DOI":"10.1542\/peds.2025-071425"},{"key":"2798_CR2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.122.025784","volume":"11","author":"CH Backes","year":"2022","unstructured":"Backes CH, Hill KD, Shelton EL, Slaughter JL, Lewis TR, Weisz DE, et al. Patent Ductus Arteriosus: A Contemporary Perspective for the Pediatric and Adult Cardiac Care Provider. J Am Heart Assoc. 2022;11:e025784. https:\/\/doi.org\/10.1161\/JAHA.122.025784.","journal-title":"J Am Heart Assoc"},{"key":"2798_CR3","first-page":"Cd013278","volume":"12","author":"S Mitra","year":"2020","unstructured":"Mitra S, Scrivens A, von Kursell AM, Disher T. Early treatment versus expectant management of hemodynamically significant patent ductus arteriosus for preterm infants. Cochrane Database Syst Rev. 2020;12:Cd013278.","journal-title":"Cochrane Database Syst Rev"},{"key":"2798_CR4","doi-asserted-by":"publisher","first-page":"Cd013588","DOI":"10.1002\/14651858.CD013588.pub2","volume":"4","author":"S Mitra","year":"2023","unstructured":"Mitra S, de Boode WP, Weisz DE, Shah PS. Interventions for patent ductus arteriosus (PDA) in preterm infants: an overview of Cochrane Systematic Reviews. Cochrane Database Syst Rev. 2023;4:Cd013588 https:\/\/doi.org\/10.1002\/14651858.CD013588.pub2.","journal-title":"Cochrane Database Syst Rev"},{"key":"2798_CR5","doi-asserted-by":"crossref","unstructured":"Seo YM, Kim SY, Youn YA. Improved Outcomes following a Conservative Approach to Hemodynamically Significant Patent Ductus Arteriosus: A Comparison across Two Periods. Cardiology. 2025:150;294\u2013302.","DOI":"10.1159\/000541477"},{"key":"2798_CR6","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1016\/j.echo.2023.11.016","volume":"37","author":"PJ McNamara","year":"2024","unstructured":"McNamara PJ, Jain A, El-Khuffash A, Giesinger R, Weisz D, Freud L, et al. Guidelines and Recommendations for Targeted Neonatal Echocardiography and Cardiac Point-of-Care Ultrasound in the Neonatal Intensive Care Unit: An Update from the American Society of Echocardiography. J Am Soc Echocardiogr. 2024;37:171\u2013215.","journal-title":"J Am Soc Echocardiogr"},{"key":"2798_CR7","doi-asserted-by":"publisher","first-page":"2459","DOI":"10.1007\/s00431-022-04441-8","volume":"181","author":"T Hundscheid","year":"2022","unstructured":"Hundscheid T, El-Khuffash A, McNamara PJ, de Boode WP. Survey highlighting the lack of consensus on diagnosis and treatment of patent ductus arteriosus in prematurity. Eur J Pediatr. 2022;181:2459\u201368.","journal-title":"Eur J Pediatr"},{"key":"2798_CR8","doi-asserted-by":"publisher","first-page":"103718","DOI":"10.1016\/j.eclinm.2025.103718","volume":"91","author":"S Gupta","year":"2025","unstructured":"Gupta S, O\u2019Connor H, Juszczak E, Subhedar NV, Bowler U, et al. Corrigendum to \u2018Two-year outcomes after selective early treatment of patent ductus arteriosus with ibuprofen in preterm babies: follow-up of Baby-OSCAR-a randomised controlled trial\u2019 [eClinicalMedicine, Volume 87, September 2025, 103424]. EClinicalMedicine. 2025;91:103718. https:\/\/doi.org\/10.1016\/j.eclinm.2025.103718.","journal-title":"EClinicalMedicine"},{"key":"2798_CR9","first-page":"612","volume":"90","author":"P Morville","year":"2017","unstructured":"Morville P, Akhavi A. Transcatheter closure of hemodynamic significant patent ductus arteriosus in 32 premature infants by amplatzer ductal occluder additional size-ADOIIAS. Catheter Cardiovasc Inter. 2017;90:612\u20137.","journal-title":"Catheter Cardiovasc Inter"},{"key":"2798_CR10","doi-asserted-by":"publisher","first-page":"e2023061460","DOI":"10.1542\/peds.2023-061460","volume":"152","author":"AR Bischoff","year":"2023","unstructured":"Bischoff AR, Kennedy KF, Backes CH, Sathanandam S, McNamara PJ. Percutaneous Closure of the Patent Ductus Arteriosus in Infants \u22642 kg: IMPACT Registry Insights. Pediatrics. 2023;152:e2023061460.","journal-title":"Pediatrics"},{"key":"2798_CR11","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1016\/j.jpeds.2020.10.024","volume":"229","author":"A El-Khuffash","year":"2021","unstructured":"El-Khuffash A, Bussmann N, Breatnach CR, Smith A, Tully E, Griffin J, et al. A Pilot Randomized Controlled Trial of Early Targeted Patent Ductus Arteriosus Treatment Using a Risk Based Severity Score (The PDA RCT). J Pediatr. 2021;229:127\u201333. https:\/\/doi.org\/10.1016\/j.jpeds.2020.10.024.","journal-title":"J Pediatr"},{"key":"2798_CR12","doi-asserted-by":"publisher","first-page":"e463","DOI":"10.1542\/peds.2014-3819","volume":"136","author":"DT Selewski","year":"2015","unstructured":"Selewski DT, Charlton JR, Jetton JG, Guillet R, Mhanna MJ, et al. Neonatal Acute Kidney Injury. Pediatrics. 2015;136:e463\u201373. https:\/\/doi.org\/10.1542\/peds.2014-3819.","journal-title":"Pediatrics"}],"container-title":["Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41372-026-02798-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41372-026-02798-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41372-026-02798-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T07:49:20Z","timestamp":1784533760000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41372-026-02798-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,20]]},"references-count":12,"alternative-id":["2798"],"URL":"https:\/\/doi.org\/10.1038\/s41372-026-02798-4","relation":{},"ISSN":["0743-8346","1476-5543"],"issn-type":[{"value":"0743-8346","type":"print"},{"value":"1476-5543","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,20]]},"assertion":[{"value":"5 October 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 May 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 June 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 July 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"All authors report no relevant financial disclosures or conflicts of interest related to this study or manuscript.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Ethics"}}]}}