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

Anna Sellmer; Vibeke Elisabeth Hjortdal; Jesper Vandborg Bjerre; Michael Rahbek Schmidt; Patrick J McNamara; Bodil Hammer Bech; Tine Brink Henriksen

doi:10.1371/journal.pone.0140079

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

Journal article

Open access

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

Anna Sellmer, Vibeke Elisabeth Hjortdal, Jesper Vandborg Bjerre, Michael Rahbek Schmidt, Patrick J McNamara, Bodil Hammer Bech and Tine Brink Henriksen

PloS one, Vol.10(10), pp.e0140079-e0140079

2015

DOI: 10.1371/journal.pone.0140079

PMCID: PMC4599729

PMID: 26452045

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Abstract

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. 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. 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. 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. 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.

Humans

Risk Factors

Infant

Male

Biomarkers - blood

Premature Birth - blood

Bronchopulmonary Dysplasia - diagnostic imaging

Infant, Extremely Premature - blood

Bronchopulmonary Dysplasia - complications

Bronchopulmonary Dysplasia - blood

Peptide Fragments - blood

Ultrasonography

Denmark

Female

Ductus Arteriosus, Patent - diagnostic imaging

Infant, Newborn

Natriuretic Peptide, Brain - blood

Cohort Studies

Details

Title: Subtitle: N-Terminal Pro-B Type Natriuretic Peptide as a Marker of Bronchopulmonary Dysplasia or Death in Very Preterm Neonates: A Cohort Study
Creators: Anna Sellmer - Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark; Perinatal Epidemiology Research Unit, Aarhus University, Aarhus, Denmark; Department of Pediatrics, Herning Regional Hospital, Herning, Denmark
Vibeke Elisabeth Hjortdal - Department of Cardiothoracic surgery, Aarhus University Hospital, Aarhus, Denmark
Jesper Vandborg Bjerre - Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark
Michael Rahbek Schmidt - Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
Patrick J McNamara - Division of Neonatology, Hospital for Sick Children, Toronto, Canada
Bodil Hammer Bech - Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
Tine Brink Henriksen - Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark; Perinatal Epidemiology Research Unit, Aarhus University, Aarhus, Denmark
Resource Type: Journal article
Publication Details: PloS one, Vol.10(10), pp.e0140079-e0140079
DOI: 10.1371/journal.pone.0140079
PMID: 26452045
PMCID: PMC4599729
NLM abbreviation: PLoS One
ISSN: 1932-6203
eISSN: 1932-6203
Publisher: Public Library of Science
Language: English
Date published: 2015
Academic Unit: Stead Family Department of Pediatrics; Neonatology; Internal Medicine
Record Identifier: 9984093323802771

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