What is the clinical evidence from this study?

Study design: Observational. Population: Healthy term neonates (n=153). Intervention: Plasma N-ANP and N-BNP measurement vs. Age groups (day of delivery vs 1-30 days). Primary outcome: Plasma N-ANP and N-BNP concentrations (p=<0.0001).

What does this research mean for the field?

Plasma N-ANP and N-BNP concentrations in healthy neonates peak significantly on the first day of life compared to the day of delivery, before steadily decreasing to stable levels within the first week. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

October 1, 2003

Plasma Concentrations of Aminoterminal Pro Atrial Natriuretic Peptide and Aminoterminal Pro Brain Natriuretic Peptide in Healthy Neonates: Marked and Rapid Increase After Birth

Q: What are the key findings of this study?

Plasma N-ANP and N-BNP concentrations in healthy neonates peaked on the first day of life (96,700 and 641 fmol/mL) compared to the day of delivery (5,680 and 221 fmol/mL; P<0.0001).

Q: What does this research mean for the field?

Plasma N-ANP and N-BNP concentrations in healthy neonates peak significantly on the first day of life compared to the day of delivery, before steadily decreasing to stable levels within the first week. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Key Result

Plasma N-ANP and N-BNP concentrations in healthy neonates peaked on the first day of life (96,700 and 641 fmol/mL) compared to the day of delivery (5,680 and 221 fmol/mL; P<0.0001).

Study Design

Type

Observational (n=153)

Structured PICO

Population

153 healthy term neonates (mean age: 5.1 days; range: 0-30 days)

Outcome

Plasma N-terminal pro atrial natriuretic peptide (N-ANP) and N-terminal pro brain natriuretic peptide (N-BNP) concentrationssurrogate

N-ANP and N-BNP levels show a marked physiological increase during the first days of life in healthy term neonates, which is critical for establishing normal reference ranges in this population.

Main Result

p-value: p=<0.0001

Abstract

OBJECTIVE: The purpose of the study was to examine the possible age dependency of plasma N-terminal pro atrial natriuretic peptide (N-ANP) and N-terminal pro brain natriuretic peptide (N-BNP) levels in healthy term neonates to establish normal ranges for the neonatal period. METHODS: N-ANP and N-BNP plasma concentrations were measured in peripheral venous (n = 116) and umbilical cord blood (n = 37) in 153 healthy term neonates (mean: 5.1; range: 0-30 days) using an enzyme immunoassay. The neonates were classified into 8 groups according to their age (day of delivery and 1, 2, 3, 4, 5-7, 8-14, and 14-30 days of age). RESULTS: The plasma N-ANP and N-BNP concentration were the highest at the first day of age (96 700; 6912-436 000 and 641; 254-1272 fmol/mL) and were found significantly higher compared with the day of delivery (5680; 1005-16 900 and 221; 58-478 fmol/mL; P < 0,0001). After this marked increase, N-ANP and N-BNP levels decreased steadily and became stable at the fifth (5232; 2691-7353 fmol/mL) and third (246; 110-430 fmol/mL) day of life, respectively. CONCLUSIONS: The N-ANP and N-BNP plasma concentrations in healthy neonates showed a marked increase during the first days of age, suggesting that ANP and BNP have physiologic roles in the perinatal circulatory change from fetus to neonate.

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