Stable Precursor Fragments of Vasoactive Peptides in Umbilical Cord Blood of Term and Preterm Infants

Abstract

Background:Though various neurohormonal systems are concurrently activated during birth, their biological effectors are not always easy to measure due to their short half-life in vivo, instability in biological samples, or very low concentrations. Methods: Using a recently discovered chemiluminescence assay, we measured the stable precursor fragments mid-regional pro-atrial natriuretic peptide (MR-proANP), mid-regional pro-adrenomedullin (MR-proADM), C-terminal pro-endothelin-1 (CT-proET-1) and C-terminal pro-vasopressin (CT-proAVP or copeptin) immediately after birth in umbilical venous cord blood from 119 infants with a gestational age of 23–42 weeks and evaluated their possible functions. Results:Cord blood levels of MR-proANP, MR- proADM, CT-proET-1, and CT-proAVP were considerably higher compared with normal adult levels. The CT-proAVP concentrations were 10-fold higher in term, and 70-fold higher in extremely preterm infants. MR-proANP showed 4-fold higher levels in term infants and 20-fold higher levels in extremely preterm infants. Levels of MR-proADM and CT-proET-1 were 2- to 3-fold higher in preterm and term infants. All four parameters showed significantly decreased values with increasing gestational age and a significant correlation between CT-proET-1 and MR-proADM. Conclusion:Our results indicate that vasoactive and natriuretic mediators play a functionally relevant role in circulatory transition from fetal to neonatal life.

Diagnostic performance and reference values of novel biomarkers of paediatric heart failure

“…While paediatric reference values have been published recently for GDF-15 and sST2, such normal data for MR-proANP and MR-proADM outside of the neonatal period are largely unavailable 19 29 30. In our reference population, MR-proANP was significantly higher in the first year of life, in keeping with the previous studies on B-type natriuretic peptides 6.…”

Cardiovascular Biomarkers in Amniotic Fluid, Umbilical Arterial Blood, Umbilical Venous Blood, and Maternal Blood at Delivery, and Their Reference Values for Full-Term, Singleton, Cesarean Deliveries

“…We calculated reference values for biomarkers in healthy term pregnancies in AF, UAB, UVB, and MATB. In addition to previous literature data on the examined biomarkers (1–11, 18–26), this study combined neonatal and maternal biomarker levels in different body fluids, including AF. We did not examine the prognostic relevance of individual biomarkers (23, 27).…”

NT-proBNP Concentrations in the Umbilical Cord and Serum of Term Neonates: A Systematic Review and Meta-Analysis

“…Soldin et al study [ 43 ] reported that during the neonatal period, NT-proBNP levels were elevated up to 20 times in comparison to infancy, even though the study population was limited in size. Additionally, NT-proBNP levels slowly decrease and gradually approach the adult reference range, as demonstrated in the studies of Rauh et al [ 41 ], Koch et al [ 53 ], and Deng et al [ 48 ]. Schwachtgen et al [ 26 ], on the other hand, observed a rapid NT-proBNP increase during the first 2 days of life, when compared to their respective UCB levels, which is succeeded by a rapid decrease during the first year of life, that persists until normal values are achieved approximately at early adulthood.…”