Am J Perinatol
DOI: 10.1055/s-0041-1740213
Original Article

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

1  Department of Neonatology, Cleveland Clinic Children's, Cleveland, Ohio
,
Rania Salah Elzayat
2  Department of Pediatrics, Menoufia University Hospitals, Menoufia, Egypt
,
Mostafa Abdo
2  Department of Pediatrics, Menoufia University Hospitals, Menoufia, Egypt
,
Hamed M. Elsharkawy
3  Department of Pediatrics, Tanta University Hospitals, Tanta, Egypt
,
Maha Allam
4  Department of Clinical Pathology, National Liver Institute, Menoufia, Egypt
,
Dina Abdelrazek Midan
2  Department of Pediatrics, Menoufia University Hospitals, Menoufia, Egypt
› Author Affiliations
Funding None.

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.

Ethics Approval

The study was approved by the local Ethics Committee of Faculty of Medicine, Menoufia University, and it complies with the Helsinki Declaration of 1964, as revised in 2013.


Consent to Participate

Written informed consent was obtained from the parents of all subjects of the study before enrollment.


Authors Contributions

Drs. Elgendy, Allam, Elsharkawy, and Midan conceptualized and designed the study, interpreted the statistical analyses, drafted the initial manuscript, reviewed and revised the manuscript, coordinated and supervised data collection, and critically reviewed the manuscript for important intellectual content. Drs. Abdo and Elzayat conceptualized and designed the study, performed the initial analyses, and critically reviewed the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.




Publication History

Received: 07 April 2021

Accepted: 14 October 2021

Publication Date:
02 December 2021 (online)

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