Objective <p>The impact of patent ductus arteriosus (PDA) and its management on necrotizing enterocolitis (NEC) and bronchopulmonary dysplasia (BPD) risk in preterm infants remains debated.</p> Methods <p>The present single-center study enrolled a total of 769 preterm infants with a gestational age of less than 37 weeks. The logistic regression was used to identify independent risk factors for PDA, NEC, and BPD based on maternal conditions during pregnancy, delivery details, and postnatal neonatal characteristics. Furthermore, the present study evaluated the effects of drug treatment for PDA on neonatal outcomes.</p> Results <p>The incidence of NEC was not associated with the presence of PDA in preterm infants (<i>P</i> = 0.15). However, infants with PDA had a 2.12-fold higher likelihood of developing BPD compared to those without PDA (<i>P</i> &lt; 0.01). Pharmacotherapy for PDA was associated with a 49% lower incidence of NEC and a 59% higher incidence of BPD (<i>P</i> &lt; 0.01). Assisted reproductive technology and maternal diabetes were identified as factors independently associated with PDA in preterm infants. Additionally, infants delivered by cesarean section had a 42% lower incidence of BPD compared to those delivered vaginally (<i>P</i> &lt; 0.01).</p> Conclusion <p>Pharmacotherapy for PDA was independently associated with a lower risk of NEC but a higher risk of BPD in preterm infants. ART was an independent risk factor for PDA and served as a confounding factor for NEC. Cesarean delivery was independently associated with a lower risk of BPD.</p>