Ayhan CERI
Perinatal Journal - 2026;34(2):640-649
The systemic vascular effects of phototherapy remain incompletely understood, with conflicting evidence regarding its influence on Ductus Arteriosus (DA) closure. We aimed to evaluate the association between phototherapy and DA patency in term and preterm neonates using a reanalyzed historical cohort. In this retrospective cohort study, 229 neonates hospitalized between November 1994 and August 1995 were included. Infants were classified into phototherapy (n=111) and control (n=118) groups. Echocardiographic assessments were performed using blinded two-dimensional and color Doppler imaging. The primary outcome was persistent DA patency. DA patency was identified in 12 infants (5.2%). The incidence was higher in preterm compared to term neonates (8.1% vs. 3.9%). Phototherapy exposure was not significantly associated with increased DA patency (odds ratio [OR]: 0.75; 95% confidence interval [CI]: 0.23-2.43; p=0.628). The relatively small number of events and wide confidence intervals suggest limited statistical power to detect modest effects. The historical nature of the cohort, predating modern LED phototherapy and early pharmacologic ductal interventions, allowed evaluation in a relatively low-confounding physiological setting. Phototherapy was not associated with a statistically significant change in DA patency in this cohort. However, given the biological plausibility of light-induced vascular effects and the uncertainty reflected in wide confidence intervals, a clinically relevant effect cannot be excluded, particularly in preterm infants. These findings highlight the need for adequately powered prospective studies incorporating modern phototherapy technologies and biochemical markers.
