Brain-type natriuretic peptide at birth reflects foetal maturation and antenatal stress.
OBJECTIVE
Antenatal stress, maturation and other foetal conditions affect the postnatal cardiovascular function. Atrial- (ANP) and brain-type natriuretic peptide (BNP) play important roles in regulating extracellular fluid volume and blood pressure, which may surrogate the foetal cardiovascular condition. The aim of this study was to investigate the dependence of serum ANP and BNP at birth on antenatal variables in high-risk infants.


METHODS
Plasma ANP and BNP levels in the umbilical cord blood were compared with antenatal clinical information in 280 infants.


RESULTS
High levels of ANP and BNP were associated with multiple pregnancy, antenatal magnesium sulphate and foetal distress. Caesarean section (CS) was paradoxically associated with low ANP and high BNP; low ANP was related with CS before labour whereas high BNP was related with CS after the commencement of labour. High BNP levels further correlated with younger gestational age and intrauteral growth restriction. With regard to short-term postnatal variables, high BNP levels were associated with low Apgar scores and respiratory failure whereas high ANP only correlated with the latter.


CONCLUSIONS
High natriuretic peptide levels were associated with prematurity at birth, uteral contraction and antenatal stress: cord blood ANP and BNP may be a useful surrogate marker for hidden antenatal stress.
Kanbe
Taro
T
Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan. lars.welzing@uk-koeln.de
Maeno
Yasuki
Y
Fujino
Hiroshi
H
Kanda
Hiroshi
H
Hirose
Akiko
A
Okada
Junichiro
J
Morikawa
Toshihiko
T
Iwata
Sachiko
S
Iwata
Osuke
O
Matsuishi
Toyojiro
T
D000704:Analysis of Variance; D009320:Atrial Natriuretic Factor / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002320:Cardiovascular Physiological Phenomena; D002585:Cesarean Section; D005260:Female; D047109:Fetal Development; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis*; D007234:Infant, Premature; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D012307:Risk Factors; D013312:Stress, Physiological
D015415:Biomarkers; D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor