Association between blood spot transforming growth factor-β and patent ductus arteriosus in extremely low-birth weight infants.
Permanent ductal closure involves anatomic remodeling, in which transforming growth factor (TGF)-β appears to play a role. Our objective was to evaluate the relationship, if any, between blood spot TGF-β on day 3 and day 7 of life and patent ductus arteriosus (PDA) in extremely low birth weight (ELBW) infants. Prospective observational study involving ELBW infants (n = 968) in the National Institute of Child Health and Human Development Neonatal Research Network who had TGF-β measured on filter paper spot blood samples using a Luminex assay. Infants with a PDA (n = 493) were significantly more immature, had lower birth weights, and had higher rates of respiratory distress syndrome than those without PDA (n = 475). TGF-β on days 3 and 7 of life, respectively, were significantly lower among neonates with PDA (median 1,177 pg/ml [range 642-1,896]; median 1,386 pg/ml [range 868-1,913]) compared with others without PDA (median 1,334 pg/ml [range 760-2,064]; median 1,712 pg/ml [range 1,014-2,518 pg/ml]). The significant difference persisted when death or PDA was considered a composite outcome. TGF-β levels were not significantly different among subgroups of infants with PDA who were not treated (n = 51) versus those who were treated medically (n = 283) or by surgical ligation (n = 159). TGF-β was not a significant predictor of death or PDA (day 3 odds ratio [OR] 0.99, 95 % confidence interval [CI] 0.83-1.17; day 7 OR 0.88, 95 % CI 0.74-1.04) on adjusted analyses. Our results suggest that blood spot TGF-β alone is unlikely to be a reliable biomarker of a clinically significant PDA or its responsiveness to treatment.
Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI 48201, USA. gnatara@med.wayne.edu
Girija
G
Natarajan
Seetha
S
Shankaran
Scott A
SA
McDonald
Abhik
A
Das
Richard A
RA
Ehrenkranz
Ronald N
RN
Goldberg
Barbara J
BJ
Stoll
Jon E
JE
Tyson
Rosemary D
RD
Higgins
Diana
D
Schendel
David M
DM
Hougaard
Kristin
K
Skogstrand
Poul
P
Thorsen
Waldemar A
WA
Carlo
D004374:Ductus Arteriosus, Patent / Q000097:blood* / Q000150:complications; D005260:Female; D006801:Humans; D007223:Infant; D052577:Infant, Extremely Low Birth Weight / Q000097:blood*; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D012127:Respiratory Distress Syndrome, Newborn / Q000097:blood / Q000453:epidemiology*; D016212:Transforming Growth Factor beta / Q000097:blood*
D016212:Transforming Growth Factor beta