European Journal of Pediatrics

, Volume 173, Issue 11, pp 1491–1496 | Cite as

Serial N-terminal pro-brain natriuretic peptide measurement as a predictor of significant patent ductus arteriosus in preterm infants beyond the first week of life

  • Johannes Buca Letshwiti
  • Jan Sirc
  • Ruth O’Kelly
  • Jan Miletin
Original Article


The aim of the study was to assess the role of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) concentration as a predictor of patent ductus arteriosus (PDA) in very low birth weight infants beyond the first week of life. This was a prospective observational study; newborns with a birth weight < 1500 g were eligible for enrolment. Enrolled infants were screened by echocardiography on day seven of life for the presence of a PDA. This was paired with a blood sample for NT-proBNP level. Echocardiography and NT-proBNP levels were repeated at weekly intervals. The primary outcome was correlation between PDA and NT-proBNP level and between measurements of PDA significance and NT-proBNP. Sixty-nine neonates were enrolled following parental consent. The mean birth weight was 1119 ± 257 g and mean gestational age was 28.6 ± 2.6 weeks. Median NT-proBNP level on day seven was 11469 ng/l in infants with a PDA vs. 898 ng/l in infants without a PDA (p < 0.0001). There was a statistically significant correlation between PDA diameter and NT-proBNP level on day seven, day 14 and day 21.Conclusion: NT-proBNP concentration is significantly increased in infants with a PDA and correlates well with PDA diameter in the first three weeks of life.

Key words

N-terminal pro-brain natriuretic peptide Patent ductus arteriosus Prematurity Very low birth weight infant 



bronchopulmonary dysplasia


B-type natriuretic peptide


Electrochemiluminescence Immunoassay


haemodynamically significant PDA


intraventricular haemorrhage


Left Atrium to Aorta ratio


PDA to Left Pulmonary Artery ratio


necrotising enterocolitis


N-terminal pro-brain natriuretic peptide


patent ductus arteriosus


positive end expiratory pressure


receiver operator characteristic


retinopathy of prematurity


very low birth weight


Conflict of interests

Authors have no conflict of interest. This study was not supported or sponsored by any manufacturer or industrial body.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Johannes Buca Letshwiti
    • 1
  • Jan Sirc
    • 1
    • 2
  • Ruth O’Kelly
    • 3
  • Jan Miletin
    • 1
    • 2
    • 4
  1. 1.Neonatal Intensive Care UnitCoombe Women and Infants University HospitalDublinIreland
  2. 2.Neonatal Intensive Care UnitInstitute for the Care of Mother and ChildPragueCzech Republic
  3. 3.Biochemistry DepartmentCoombe Women and Infants University HospitalDublinIreland
  4. 4.Department of PaediatricsUCD School of Medicine and Medical SciencesDublinIreland

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