NTproBNP is a useful early biomarker of bronchopulmonary dysplasia in very low birth weight infants
Bronchopulmonary dysplasia (BPD) is a severe complication of prematurity that impacts survival and neurodevelopment. Currently, no early marker exists which could help clinicians identify which preterm infants will develop BPD. Given the evidence that NTproBNP is elevated in children with BPD, we hypothesized that it could be used as an early marker of BPD development. We conducted a prospective cohort study including very low birth weight infants (VLBWI) admitted to our NICU between January 2015 and January 2017 in which we determined serial NTproBNP levels on days 1 and 3 and then weekly, until 49 days of life. A total of 101 patients were recruited (mean birth weight 1152 g (SD 247.5), mean gestational age 28.9 weeks (SD 1.9)). NTproBNP levels differed among infants who did and did not develop BPD from 14 to 35 days of life with the greatest difference on day 14 of life (non-BPD group (n = 86): 1155 (IQR 852–1908) pg/mL, BPD (n = 15): 9707 (IQR 3212–29,560) pg/mL; p = 0.0003). The presence of HsPDA did not account for higher levels of NTproBNP at day 14 (p = 0.165). We calculated an optimal cutoff point of 2264 pg/mL at 14 days of life (sensitivity 100%, specificity 86% and AUC 0.93).
What is Known:
• Children with BPD have elevated NTproBNP levels, which are related to the severity of BPD and the development of pulmonary hypertension.
What is New:
• NTproBNP at 14 days of life is higher in those who later develop BPD, regardless of the presence of hemodynamically significant patent ductus arteriosus.
• A calculated cutoff point of 2264 pg/mL of NTproBNP at 14 days has a sensitivity of 100% and specificity of 86% in the prediction of BPD.
KeywordsBronchopulmonary dysplasia Pro-brain natriuretic peptide Preterm infant Biomarkers
Area under the curve
Brain natriuretic peptide
Clinical risk index for babies
Hemodynamically significant patent ductus arteriosus
Negative predictive value
N-terminal pro-brain natriuretic peptide
Patent ductus arteriosus
Positive predictive value
Receiver operator curve
Retinopathy of prematurity
Very low birth weight infants
PMA: Concept/design, Data analysis/interpretation, Drafting article, Approval of article, Data collection
PZR: Concept/design, Data analysis/interpretation, Drafting article, Approval of article, Data collection
SLL: Concept/design, Critical revision of article, Approval of article
IBF: Concept/design, Data analysis/interpretation, Critical revision of article, Approval of article, Statistics
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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