Key result
High umbilical cord blood (>90 pg/mL) and amniotic fluid (>36 pg/mL) BNP levels at birth predicted the need for dopamine administration with sensitivities of 68% and 93%, respectively.
Why the study?
Do B-type natriuretic peptide levels in umbilical cord blood and amniotic fluid predict cardiac dysfunction and hypotension in neonates soon after birth?
Observational (n=320)
Do B-type natriuretic peptide levels in umbilical cord blood and amniotic fluid predict cardiac dysfunction and hypotension in neonates soon after birth?
High B-type natriuretic peptide levels in umbilical cord blood and amniotic fluid can predict the need for dopamine administration due to cardiac dysfunction in neonates soon after birth.
BACKGROUND: Although the B-type natriuretic peptide (BNP) levels in the umbilical cord blood (UCB-BNP) and amniotic fluid (AF-BNP) of neonates may be clinically useful for identifying newborns with cardiac dysfunction, the effects of various clinical factors, such as gestational age at birth, small for gestational age (SGA), and neonatal asphyxia, on the UCB-BNP and AF-BNP levels have not been studied extensively. METHODS: The present study sought to determine whether the UCB-BNP and AF-BNP levels can predict cardiac dysfunction and hypotension in preterm infants soon after birth and to evaluate the association between BNP and various clinical factors. The UCB-BNP and AF-BNP levels at birth were determined in 320 and 195 neonates, respectively, born to mothers with singleton pregnancies. RESULTS: The UCB-BNP and AF-BNP levels in infants treated with dopamine were significantly higher than those in infants without dopamine administration (230.1 vs 33.1 pg/mL and 74.4 vs 18.1 pg/mL, respectively). Stepwise multiple regression analyses indicated that gestational age, SGA, asphyxia, and chorioamnionitis were significant independent determinants of the UCB-BNP level. Cut-off values of >90 pg/mL for UCB-BNP and >36 pg/mL for AF-BNP yielded sensitivities of 68% and 93%, respectively, and specificities of 84% and 81%, respectively, for detecting neonates who required dopamine administration after birth. CONCLUSION: High UCB-BNP and AF-BNP levels predict neonatal cardiac dysfunction soon after birth.
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Moriichi et al. (2011) conducted an observational in Neonatal cardiac dysfunction (n=320). High umbilical cord blood and amniotic fluid BNP levels vs. Low BNP levels was evaluated on Requirement of dopamine administration after birth. High umbilical cord blood (>90 pg/mL) and amniotic fluid (>36 pg/mL) BNP levels at birth predicted the need for dopamine administration with sensitivities of 68% and 93%, respectively.
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