Effectiveness of B-type Natriuretic Peptide in Caring for Preterm Infants

Department of Pediatrics, Pusan National University School of Medicine, Yangsan, Korea Objective: Volume and pressure loading of the ventricles are associated with increased plasma Btype natriuretic peptide (BNP) levels. Hemodynamically significant patent ductus arteriosus (hsPDA) is a risk factor for life-threatening conditions in preterm infants. We compared follow-up data such as echocardiograms, BNP levels, comorbidities, and prognosis in preterm infants with PDA, and investigated the relationship between maternal prenatal factors and BNP. Methods: This single-center study performed between January 2015 and August 2016 included 63 preterm infants with a gestational age of <35 weeks. We retrospectively evaluated the BNP levels on postnatal day 1, 3, and 7, clinical features, treatment method for PDA, mortality, and maternal prenatal factors. Results: Lower gestational age and smaller birth weight were associated with a higher incidence of hsPDA (P<0.01). Postnatal day 3 BNP levels were significantly higher in the hsPDA group. BNP levels were not associated with failure of medication in the hsPDA group. Postnatal day 1 BNP levels were associated with an abnormal umbilical artery flow (P=0.017), and deceleration in fetal non-stress test result (P=0.01) but not with other maternal states. Conclusion: BNP levels are a useful predictive biomarker for hsPDA in preterm infants during the 3rd days of life; however, they do not help in decision-making regarding treatment. BNP levels on the 1st postnatal day showed a positive correlation with prenatal factors such as abnormal umbilical artery flow and deceleration in fetal NST result.