Urinary N-terminal Pro-Brain Natriuretic Peptide in Newborn Infants with Cardiac and Pulmonary Diseases

Abstract

Objectives The aim of this study was to assess the feasibility of urinary N-terminal pro-brain natriuretic peptide (NT-proBNP) as noninvasive screening tool for congenital heart diseases in full-term neonates with respiratory distress. Study Design A prospective cohort study was conducted on 90 full-term infants. Newborn were assigned into three groups: pulmonary, cardiac, and control groups. Urinary NT-proBNP were measured in all studied groups at day 1 (NT-proBNP1) and day 5 (NT-proBNP5). Results Urinary NT-proBNP1 was higher in cardiac group compared with pulmonary and control groups (488 ± 91, 321 ± 80, and 218 ± 41 ng/L, respectively; p ≤ 0.001). NT-proBNP5 was lower in pulmonary and control group than cardiac group (245 ± 84, 137 ± 39, and 546 ± 284 ng/L, respectively, with p ≤ 0.001). Receiver operating characteristic (ROC) analysis was performed to assess predictive value of NT-proBNP1 in cardiac and pulmonary populations. ROC showed area under curve of 0.97 and cutoff point of ≥386.5 ng/L referring to a cardiac etiology with sensitivity of 93.3%, specificity of 86.7%, negative predictive value of 93%, and positive predictive value of 88%. Conclusion Urinary NT-proBNP is feasible to be a noninvasive screening tool to predict congenital heart diseases in full-term neonates. Further studies are needed to assess the correlation between plasma and urinary levels of NT-proBNP in congenital heart diseases in full-term and preterm infants.

Correlation between urinary and serum NT‐proBNP in acute bronchiolitis: A pilot study

“…Several studies have demonstrated that NT‐proBNP levels are detectable in the urine of preterm newborns with significant associations between elevated urinary NT‐proBNP concentrations and neonatal morbidities such as hs‐PDA, retinopathy of prematurity, and BPD with pulmonary hypertension 12–14,18 . Urinary NT‐proBNP also seems promising as a screening tool for CHD in term newborns and has shown potential to differentiate simple and complex CHD 11,19 . Furthermore, urinary‐NT‐proBNP would be helpful in the pediatric ambulatory setting to assess heart failure when combined with clinical scores 20 .…”

“…[12][13][14]18 Urinary NT-proBNP also seems promising as a screening tool for CHD in term newborns and has shown potential to differentiate simple and complex CHD. 11,19 Furthermore, urinary-NT-proBNP would be helpful in the pediatric ambulatory setting to assess heart failure when combined with clinical scores. 20 Like these populations, obtaining blood samples for testing in acute bronchiolitis is technically challenging for the healthcare provider and stressful and painful for the patient, especially in cases where repeated tests are needed for monitoring evolution.…”

Correlation between urinary and serum NT-proBNP in acute bronchiolitis. A pilot study

“…These investigations have reported significant associations between elevated urinary NT-proBNP concentrations and neonatal morbidities such as hemodynamically significant persistent ductus arteriosus, retinopathy of prematurity, and bronchopulmonary dysplasia with pulmonary hypertension [12,14,18,19]. Urinary NT-proBNP also seems promising as a screening tool for congenital heart diseases in newborns and has shown potential to differentiate simple and complex CHD [11,20]. Recently, urinary-NT-proBNP has been helpful in the pediatric ambulatory setting to assess heart failure in children with congenital heart diseases when combined with clinical scores [21].…”