Abstract
Background
To validate the findings of a single-center pilot study showing elevated urinary N-terminal B-type natriuretic peptide (NTproBNP) concentrations in preterm infants subsequently developing severe retinopathy of prematurity (ROP) in a multicenter setting across eight European and Middle East countries.
Methods
Prospective observational study in 967 preterm infants <30 weeks’ gestational age assessing the capacity of urinary NTproBNP on days of life (DOLs) 14 and 28 to predict ROP requiring treatment.
Results
Urinary NTproBNP concentrations were markedly elevated in infants who developed ROP requiring treatment (n=94) compared with survivors without ROP treatment (n=837), at both time points (median (interquartile range) DOL14: 8,950 (1,925–23,783) vs. 3,083 (1,193-17,393) vs. 816 (290-3,078) pg/ml, P<0.001) and DOL28 (2,203 (611–4,063) vs. 1,671 (254–11,340) vs. 408 (162–1,126) pg/ml, P<0.001). C-statistic of NTproBNP for treated ROP or death was 0.731 (95% confidence interval 0.654–0.774) for DOL14 and 0.683 (0.622–0.745) for DOL28 (P<0.001). Threshold scores were calculated, potentially enabling around 20% of infants with low NTproBNP scores never to be screened with ophthalmoscopy.
Conclusion
There is a strong association between early urinary NTproBNP and subsequent ROP development, which can be used to further refine subgroups of patients with high or low risk of severe ROP.
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REDEXAM study group
Sinan Abu-Leil12, Benjamin Bausenhardt13, Christoph Czernik14, Uğur Dilmen15,21, Nicholas Embleton16, Zivanit Ergaz-Shaltiel12, Lara Garabedian17, Irene Lok18, Tone Nordvik19, Wes Onland18, Øivind Ringen19, Thomas Skeath16, Oliver Wagner20
12Hadassah Medical Center, Jerusalem, Israel; 13Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria; 14Charité Universitätsmedizin Berlin, Berlin, Germany; 15Zekai Tahir Burak Maternity Hospital, Ankara, Turkey; 16Royal Victoria Infirmary, Newcastle upon Tyne, UK; 17Department of Development and Regeneration, Catholic University of Leuven, Leuven, Belgium; 18Emma Children’s Hospital, Academic Medical Center Amsterdam, Amsterdam, The Netherlands; 19Oslo University Hospital, Oslo, Norway; 20Kepler University Medical Center, Linz, Austria.
21Deceased.
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The study has received financial support from the BLISS innovation grant (London, UK) and intramural funding.
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Bührer, C., Erdeve, Ö., van Kaam, A. et al. N-terminal B-type natriuretic peptide urinary concentrations and retinopathy of prematurity. Pediatr Res 82, 958–963 (2017). https://doi.org/10.1038/pr.2017.179
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DOI: https://doi.org/10.1038/pr.2017.179
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