{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T23:30:56Z","timestamp":1773012656612,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"vor","delay-in-days":40,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study evaluated the effect of modifying enteral feeding during cyclooxygenase inhibitor (COXI) treatment on patent ductus arteriosus (PDA) in preterm infants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched MEDLINE, EMBASE, CENTRAL, CINAHL, and ICHUUSHI databases for randomized and nonrandomized controlled trials, checked the references lists and major clinical trials. Non\u2010human and non\u2010English studies were excluded. Evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation. Preterm infants born before 37\u2009weeks of gestation are treated with COXIs for PDA, including indomethacin and ibuprofen. The primary outcomes were the composite outcome of necrotizing enterocolitis (NEC) or gastrointestinal perforation and its components (NEC and gastrointestinal perforation).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Two randomized controlled trials (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009303) and one retrospective cohort study (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009261) were included (total:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009564). No significant differences were observed in the composite gastrointestinal outcome (risk ratio [RR]: 1.10, 95% confidence interval [CI]: 0.51\u20132.37; 1 study, 177 infants, very low certainty of evidence [CoE]), NEC (RR: 1.01, 95% CI: 0.47\u20132.15; 2 studies, 300 infants, very low CoE), or gastrointestinal perforation (RR: 1.94, 95% CI: 0.25\u201314.81; 2 studies, 300 infants, very low CoE) between discontinuation and continuation of enteral feeding. Discontinuation of enteral feeding resulted in a significantly lower rate of surgical closure for PDA compared to continuation (RR: 0.56, 95% CI: 0.37\u20130.86; 1 study, 177 infants, low CoE).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Neither discontinuation nor continuation of enteral feeding significantly affected the composite gastrointestinal outcome and its components (NEC and gastrointestinal perforation).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ped.70338","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T10:41:58Z","timestamp":1770720118000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Enteral feeding during cyclooxygenase inhibitor treatment for patent ductus arteriosus: A systematic review"],"prefix":"10.1111","volume":"68","author":[{"given":"Gakuto","family":"Ujiie","sequence":"first","affiliation":[{"name":"Department of Pediatrics Showa Medical University  Shinagawa Japan"},{"name":"Department of Neonatology Kanagawa Children's Medical Center  Yokohama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7211-1194","authenticated-orcid":false,"given":"Eriko","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Nursing Toyama Prefectural University  Imizu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miyuki","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Nursing Faculty of Human Health Sciences Shunan University  Shunan Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Motoichiro","family":"Sakurai","sequence":"additional","affiliation":[{"name":"Department of Neonatology Kameda Medical Center  Kamogawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuko","family":"Sakurai","sequence":"additional","affiliation":[{"name":"Department of Neonatology Kameda Medical Center  Kamogawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5436-6399","authenticated-orcid":false,"given":"Kosuke","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, Heersink School of Medicine University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuya","family":"Isayama","sequence":"additional","affiliation":[{"name":"Division of Neonatology National Center for Child Health and Development  Setagaya Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katsuaki","family":"Toyoshima","sequence":"additional","affiliation":[{"name":"Department of Neonatology Kanagawa Children's Medical Center  Yokohama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,10]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016-4258"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1536-4801.2005.tb00961.x"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2025-071425"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.10.049"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jp.7211548"},{"key":"e_1_2_9_7_1","article-title":"Indomethacin for symptomatic patent ductus arteriosus in preterm infants","volume":"1","author":"Evans P","year":"2021","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_8_1","article-title":"Ibuprofen for the treatment of patent ductus arteriosus in preterm or low birth weight (or both) infants","volume":"2","author":"Ohlsson A","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu12010083"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1249764"},{"key":"e_1_2_9_11_1","unstructured":"HigginsJPT ThomasJ ChandlerJ CumpstonM LiT PageMJ et\u00a0al.Cochrane handbook for systematic reviews of interventions version 6.3 (updated February 2022). 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