Urinary NT-proBNP as a potential noninvasive biomarker for screening of pulmonary hypertension in preterm infants: a pilot study

Naeem, Buria; Ayub, Adil; Aly, Ashraf M.; Malloy, Michael H.; Okorodudu, Anthony O.; Jain, Sunil K.

doi:10.1038/s41372-019-0581-9

Cited by 18 publications

(18 citation statements)

References 18 publications

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“…Urinary NT-proBNP was proven to be elevated at 7, 14, and 28 days of life in infants with ROP or BPD (32). In a retrospective study containing 54 premature babies, urinary NT-proBNP levels were higher in the BPD-PH group than in the BPD and control groups, and a cutoff level of 2,345 pg/mL at 28 weeks of GA had a sensitivity and specificity of 83.3 and 84.2%, respectively (33). Since there were several limitations due to the lack of research and the small sample size, the results need to be validated in further data.…”

Section: Discussionmentioning

confidence: 97%

Development and Validation of a Nomogram for Predicting Bronchopulmonary Dysplasia in Very-Low-Birth-Weight Infants

et al. 2021

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Background: Bronchopulmonary dysplasia is a common pulmonary disease in newborns and is one of the main causes of death. The aim of this study was to build a new simple-to-use nomogram to screen high-risk populations.Methods: In this single-center retrospective study performed from January 2017 to December 2020, we reviewed data on very-low-birth-weight infants whose gestational ages were below 32 weeks. LASSO regression was used to select variables for the risk model. Then, we used multivariable logistic regression to build the prediction model incorporating these selected features. Discrimination was assessed by the C-index, and and calibration of the model was assessed by and calibration curve and the Hosmer-Lemeshow test.Results: The LASSO regression identified gestational age, duration of ventilation and serum NT-proBNP in the 1st week as significant predictors of BPD. The nomogram-illustrated model showed good discrimination and calibration. The C-index was 0.853 (95% CI: 0.851–0.854) in the training set and 0.855 (95% CI: 0.77–0.94) in the validation set. The calibration curve and Hosmer-Lemeshow test results showed good calibration between the predictions of the nomogram and the actual observations.Conclusion: We demonstrated a simple-to-use nomogram for predicting BPD in the early stage. It may help clinicians recognize high-risk populations.

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Section: Discussionmentioning

confidence: 97%

Development and Validation of a Nomogram for Predicting Bronchopulmonary Dysplasia in Very-Low-Birth-Weight Infants

et al. 2021

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“…A recent pilot study investigated the feasibility of urinary NT-proBNP in detection of pulmonary hypertension in preterm infants with bronchopulmonary dysplasia; the study reported that NT-proBNP levels appear to be significantly elevated in preterm infants with pulmonary hypertension. 26 The timing of NT-proBNP sampling was not standardized because the clinical decision to sample urine for analysis was made at the first appearance of clinical signs of RD. This study did not evaluate renal function on day 5, which may affect the level of BNP.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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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.

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“…hypertension 16,23 . Because of the preference for a blood sparing and noninvasive approach for premature infants, many investigators have used urine instead of serum NT-proBNP as a biomarker in these infants [24][25][26] .…”

Section: Accepted Manuscriptmentioning

confidence: 99%

The Trend of Urinary N Terminal Probrain Natriuretic Peptide in Extremely Low Birth Weight Infants during the Neonatal Period

et al. 2021

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Background: NT-proBNP is a biomarker of interest in many cardiopulmonary diseases in extremely low birth weight (ELBW) Infants. However, there is a gap in knowledge about the trend of ELBW infant’s urinary NT-proBNP during the neonatal period. Aim: To determine the trend of urinary NT-proBNP during the first four weeks of life of an ELBW infant Study Design: We analyzed prospectively enrolled, 87 ELBW infants. Urinary NT-proBNP to creatinine ratios were measured on days 1-7, day 14, and day 28 of life. In addition, we plotted each study point's means to determine the trend of urinary NT-proBNP over the entire neonatal period. Data were analyzed using the Friedman ANOVA for comparative analysis of study points. Results: Urinary NT-proBNP/creatinine ratios were significantly elevated on days 1-7 (mean 2452, + 1518) than day 14 (mean 747, +176), and day 28 (mean149, +54), p=0.001. Overall, urinary NT-proBNP levels were highest during the days 1-3 (mean 3232+1255) and lowest on day 28 (mean149, +54). Conclusions: Urinary NT-proBNP levels are higher during the first week in ELBW infants with a downward trend during the neonatal period, with the lowest values at four weeks postnatal age. More studies are required to determine the clinical utility of this trend during and beyond the neonatal period.

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Urinary NT-proBNP as a potential noninvasive biomarker for screening of pulmonary hypertension in preterm infants: a pilot study

Cited by 18 publications

References 18 publications

Development and Validation of a Nomogram for Predicting Bronchopulmonary Dysplasia in Very-Low-Birth-Weight Infants

Development and Validation of a Nomogram for Predicting Bronchopulmonary Dysplasia in Very-Low-Birth-Weight Infants

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

The Trend of Urinary N Terminal Probrain Natriuretic Peptide in Extremely Low Birth Weight Infants during the Neonatal Period

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