N-Terminal Pro-B Type Natriuretic Peptide as a Marker of Bronchopulmonary Dysplasia or Death in Very Preterm Neonates: A Cohort Study.

Abstract

BACKGROUND:

Bronchopulmonary dysplasia (BPD) is a serious complication of preterm birth. Plasma N-terminal pro-B type natriuretic peptide (NT-proBNP) has been suggested as a marker that may predict BPD within a few days after birth.

OBJECTIVES:

To investigate the association between NT-proBNP day three and bronchopulmonary dysplasia (BPD) or death and further to assess the impact of patent ductus arteriosus (PDA) on this association in neonates born before 32 gestational weeks.

METHODS:

A cohort study of 183 neonates born before 32 gestational weeks consecutively admitted to the Neonatal Intensive Care Unit, Aarhus University Hospital, Denmark. On day three plasma samples were collected and echocardiography carried out. NT-proBNP was measured by routine immunoassays. The combined outcome BPD or death was assessed at 36 weeks of postmenstrual age. Receiver operator characteristic (ROC) analysis was performed to determine the discrimination ability of NT-proBNP by the natural log continuous measure to recognize BPD or death. The association of BPD or death was assessed in relation to natural log NT-proBNP levels day three.

RESULTS:

The risk of BPD or death increased 1.7-fold with one unit increase of natural log NT-proBNP day three when adjusted for gestational age at birth (OR = 1.7, 95% CI 1.3; 2.3). The association was found both in neonates with and without a PDA. Adjusting for GA, PDA diameter, LA:Ao-ratio, or early onset sepsis did not change the estimate.

CONCLUSION:

We found NT-proBNP to be associated with BPD or death in very preterm neonates. This association was not only explained by the PDA. We speculate that NT-proBNP may help the identification of neonates at risk of BPD as early as postnatal day three.

• Authors: Anna Sellmer, Vibeke Elisabeth Hjortdal, Jesper Vandborg Bjerre, Michael Rahbek Schmidt, Patrick J McNamara, Bodil Hammer Bech, Tine Brink Henriksen
• Journal: PloS one (PLoS One) Vol. 10 Issue 10 Pg. e0140079 ( 2015) ISSN: 1932-6203 [Electronic] United States
• PMID: 26452045 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers
• Peptide Fragments
• pro-brain natriuretic peptide (1-76)
• Natriuretic Peptide, Brain

Topics

• Biomarkers (blood)
• Bronchopulmonary Dysplasia (blood, complications, diagnostic imaging)
• Cohort Studies
• Denmark
• Ductus Arteriosus, Patent (diagnostic imaging)
• Female
• Humans
• Infant
• Infant, Extremely Premature (blood)
• Infant, Newborn
• Male
• Natriuretic Peptide, Brain (blood)
• Peptide Fragments (blood)
• Premature Birth (blood)
• Risk Factors
• Ultrasonography