title: N-terminal pro-brain natriuretic peptide in the assessment of respiratory distress in term neonates.
abstract: BACKGROUND
  N-terminal pro-brain natriuretic peptide (NT-proBNP) is used as a biomarker to differentiate congestive heart failure from lung disease in adults and children. The clinical significance of its use in term neonates has not yet been extensively studied.
  
  
  METHODS
  NT-proBNP level was measured in 62 term neonates admitted for respiratory distress (RD): 38 with congenital heart disease (CHD) and 24 with pulmonary disease. The control group consisted of 28 healthy neonates. Findings of auscultation, chest radiography, Silverman-Anderson score and echocardiography were recorded for each patient. Blood samples for measuring NT-proBNP were collected on admission, when blood sampling was indicated for the clinical management of the newborn.
  
  
  RESULTS
  In the control group NT-proBNP was significantly higher during the first week of life compared to the rest of the neonatal period (P < 0.001). The RD group, regardless of etiology, had significantly higher NT-proBNP than the control group (P < 0.001). Neonates with more severe RD had significantly higher NT-proBNP (P = 0.002). No significant difference was found between the RD group with CHD and those with pulmonary disease. Neonates with CHD and myocardial hypocontractility had significantly higher NT-proBNP than those with normal contractility (P = 0.022).
  
  
  CONCLUSIONS
  Term neonates with RD have significantly higher NT-proBNP than healthy neonates. A single measurement of NT-proBNP level cannot be used as the sole biomarker for distinguishing between cardiac and pulmonary cause of RD in term neonates.
authors.affiliation: Department of Neonatology, Mother and Child Health Care Institute, Belgrade, Serbia.
authors.forename: Gordana
authors.initials: G
authors.lastname: Markovic-Sovtic
authors.forename: Jovan
authors.initials: J
authors.lastname: Kosutic
authors.forename: Borisav
authors.initials: B
authors.lastname: Jankovic
authors.forename: Dragana
authors.initials: D
authors.lastname: Bojanin
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Sovtic
authors.forename: Zoran
authors.initials: Z
authors.lastname: Radojicic
authors.forename: M Zorica
authors.initials: MZ
authors.lastname: Rakonjac
mesh_terms: D015415:Biomarkers / Q000097:blood*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D012127:Respiratory Distress Syndrome, Newborn / Q000175:diagnosis*
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: N-terminal pro-brain natriuretic peptide; congenital heart disease; pulmonary disease; respiratory distress; term neonate