Pediatric Cardiology

, Volume 34, Issue 1, pp 149–154

Association Between Blood Spot Transforming Growth Factor-β and Patent Ductus Arteriosus in Extremely Low-Birth Weight Infants

Authors

    • Department of PediatricsWayne State University School of Medicine
  • Seetha Shankaran
    • Department of PediatricsWayne State University School of Medicine
  • Scott A. McDonald
    • Department of Statistics and EpidemiologyRTI International, Research Triangle Park
  • Abhik Das
    • Department of Statistics and EpidemiologyRTI International
  • Richard A. Ehrenkranz
    • Department of PediatricsYale University School of Medicine
  • Ronald N. Goldberg
    • Department of PediatricsDuke University
  • Barbara J. Stoll
    • Department of PediatricsEmory University
  • Jon E. Tyson
    • Department of PediatricsUniversity of Texas Medical School at Houston
  • Rosemary D. Higgins
    • Eunice Kennedy Shriver National Institute of Child Health and Human Development
  • Diana Schendel
    • National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention
  • David M Hougaard
    • Section of Neonatal Screening and Hormones, Department of Clinical Biochemistry and ImmunologyStatens Serum Institut
  • Kristin Skogstrand
    • Section of Neonatal Screening and Hormones, Department of Clinical Biochemistry and ImmunologyStatens Serum Institut
  • Poul Thorsen
    • Department of Obstetrics and GynecologyLillebaelt Hospital
    • Rollins School of Public HealthEmory University
  • Waldemar A. Carlo
    • Department of PediatricsUniversity of Alabama at Birmingham
Original Article

DOI: 10.1007/s00246-012-0404-7

Cite this article as:
Natarajan, G., Shankaran, S., McDonald, S.A. et al. Pediatr Cardiol (2013) 34: 149. doi:10.1007/s00246-012-0404-7
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Abstract

Permanent ductal closure involves anatomic remodeling, in which transforming growth factor (TGF)-β appears to play a role. Our objective was to evaluate the relationship, if any, between blood spot TGF-β on day 3 and day 7 of life and patent ductus arteriosus (PDA) in extremely low birth weight (ELBW) infants. Prospective observational study involving ELBW infants (n = 968) in the National Institute of Child Health and Human Development Neonatal Research Network who had TGF-β measured on filter paper spot blood samples using a Luminex assay. Infants with a PDA (n = 493) were significantly more immature, had lower birth weights, and had higher rates of respiratory distress syndrome than those without PDA (n = 475). TGF-β on days 3 and 7 of life, respectively, were significantly lower among neonates with PDA (median 1,177 pg/ml [range 642–1,896]; median 1,386 pg/ml [range 868–1,913]) compared with others without PDA (median 1,334 pg/ml [range 760–2,064]; median 1,712 pg/ml [range 1,014–2,518 pg/ml]). The significant difference persisted when death or PDA was considered a composite outcome. TGF-β levels were not significantly different among subgroups of infants with PDA who were not treated (n = 51) versus those who were treated medically (n = 283) or by surgical ligation (n = 159). TGF-β was not a significant predictor of death or PDA (day 3 odds ratio [OR] 0.99, 95 % confidence interval [CI] 0.83–1.17; day 7 OR 0.88, 95 % CI 0.74–1.04) on adjusted analyses. Our results suggest that blood spot TGF-β alone is unlikely to be a reliable biomarker of a clinically significant PDA or its responsiveness to treatment.

Keywords

Transforming growth factorPatent ductus arteriosusPretermNeonate

Abbreviations

PDA

Patent ductus arteriosus

ELBW

Extremely low birth weight

TGF

Transforming growth factor

Copyright information

© Springer Science+Business Media, LLC 2012