title: B-type natriuretic peptide levels at birth predict cardiac dysfunction in neonates.
abstract: 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.
  
  
  CONCLUSIONS
  High UCB-BNP and AF-BNP levels predict neonatal cardiac dysfunction soon after birth.
authors: Maternity and Perinatal Care Center, Hokkaido University Hospital, Sapporo, Hokkaido, Japan. akinori@med.hokudai.ac.jp
authors: Akinori
authors: A
authors: Moriichi
authors: Kazutoshi
authors: K
authors: Cho
authors: Masato
authors: M
authors: Mizushima
authors: Yuta
authors: Y
authors: Furuse
authors: Takuma
authors: T
authors: Akimoto
authors: Takashi
authors: T
authors: Yamada
authors: Hisanori
authors: H
authors: Minakami
mesh_terms: D000328:Adult; D000653:Amniotic Fluid / Q000737:chemistry*; D002821:Chorioamnionitis / Q000175:diagnosis; D004298:Dopamine / Q000494:pharmacology / Q000627:therapeutic use; D004452:Echocardiography; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D006331:Heart Diseases / Q000097:blood; D006801:Humans; D007022:Hypotension / Q000097:blood* / Q000188:drug therapy; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood*; D007235:Infant, Premature, Diseases; D008297:Male; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000032:analysis / Q000097:blood*; D011247:Pregnancy; D011446:Prospective Studies; D012044:Regression Analysis; D055815:Young Adult
chemical_list: D020097:Natriuretic Peptide, Brain; D004298:Dopamine