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

  • Girija Natarajan
  • Seetha Shankaran
  • Scott A. McDonald
  • Abhik Das
  • Richard A. Ehrenkranz
  • Ronald N. Goldberg
  • Barbara J. Stoll
  • Jon E. Tyson
  • Rosemary D. Higgins
  • Diana Schendel
  • David M Hougaard
  • Kristin Skogstrand
  • Poul Thorsen
  • Waldemar A. Carlo
Original Article

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 factor Patent ductus arteriosus Preterm Neonate 

Abbreviations

PDA

Patent ductus arteriosus

ELBW

Extremely low birth weight

TGF

Transforming growth factor

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Girija Natarajan
    • 1
  • Seetha Shankaran
    • 1
  • Scott A. McDonald
    • 2
  • Abhik Das
    • 3
  • Richard A. Ehrenkranz
    • 4
  • Ronald N. Goldberg
    • 5
  • Barbara J. Stoll
    • 6
  • Jon E. Tyson
    • 7
  • Rosemary D. Higgins
    • 8
  • Diana Schendel
    • 9
  • David M Hougaard
    • 10
  • Kristin Skogstrand
    • 10
  • Poul Thorsen
    • 11
    • 12
  • Waldemar A. Carlo
    • 13
  1. 1.Department of PediatricsWayne State University School of MedicineDetroitUSA
  2. 2.Department of Statistics and EpidemiologyRTI International, Research Triangle ParkDurhamUSA
  3. 3.Department of Statistics and EpidemiologyRTI InternationalRockvilleUSA
  4. 4.Department of PediatricsYale University School of MedicineNew HavenUSA
  5. 5.Department of PediatricsDuke UniversityDurhamUSA
  6. 6.Department of PediatricsEmory UniversityAtlantaUSA
  7. 7.Department of PediatricsUniversity of Texas Medical School at HoustonHoustonUSA
  8. 8.Eunice Kennedy Shriver National Institute of Child Health and Human DevelopmentBethesdaUSA
  9. 9.National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and PreventionAtlantaUSA
  10. 10.Section of Neonatal Screening and Hormones, Department of Clinical Biochemistry and ImmunologyStatens Serum InstitutCopenhagenDenmark
  11. 11.Department of Obstetrics and GynecologyLillebaelt HospitalKoldingDenmark
  12. 12.Rollins School of Public HealthEmory UniversityAtlantaUSA
  13. 13.Department of PediatricsUniversity of Alabama at BirminghamBirminghamUSA

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