title: N-Terminal pro-brain natriuretic peptide levels in dichorionic diamniotic twins with selective intrauterine growth restriction.
abstract: Monochorionic diamniotic (MD) twins with selective intrauterine growth restriction (sIUGR) have known associations with cardiac complications. However, the cardiac load of dichorionic diamniotic (DD) twins with sIUGR (DD-sIUGR) remains unclear. N-terminal pro-brain natriuretic peptide (NT-pro BNP) is a convenient marker of cardiac dysfunction in neonates, and is elevated in MD twins with sIUGR (MD-sIUGR). However, there are no reports assessing serum NT-pro BNP levels in DD-sIUGR. Here, we aimed to clarify serum NT-pro BNP levels at birth in DD-sIUGR, and to compare them with those of MD-sIUGR. Forty-one DD twin pairs admitted to our center between October 2007 and January 2013 were enrolled in this study and separated into two groups: nine twins with sIUGR (DD-sIUGR group) and 32 twins without sIUGR (DD without sIUGR group). Sixteen MD twins with sIUGR (MD-sIUGR group) served as positive controls. Serum NT-pro BNP levels at birth in DD-sIUGR [median 2,115 pg/ml (range, 443-6,590 pg/ml)] were significantly higher than in DD without sIUGR [1,080 pg/ml (range, 313-3,470 pg/ml); p=0.001], and significantly lower than in MD twins with sIUGR [4,520 pg/ml (range, 529-62,400 pg/ml); p=0.04]. Serum NT-pro BNP levels between larger and smaller DD co-twins were significantly correlated (r = 0.582; p<0.0001). In conclusion, serum NT-pro BNP levels at birth in DD twins with sIUGR were higher than those without, and lower than in MD twins with sIUGR.
authors.affiliation: Department of Neonatology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.
authors.forename: Kazumichi
authors.initials: K
authors.lastname: Fujioka
authors.forename: Masami
authors.initials: M
authors.lastname: Mizobuchi
authors.forename: Hitomi
authors.initials: H
authors.lastname: Sakai
authors.forename: Sota
authors.initials: S
authors.lastname: Iwatani
authors.forename: Keiko
authors.initials: K
authors.lastname: Wada
authors.forename: Seiji
authors.initials: S
authors.lastname: Yoshimoto
authors.forename: Hideto
authors.initials: H
authors.lastname: Nakao
mesh_terms: D000328:Adult; D005260:Female; D005317:Fetal Growth Retardation / Q000097:blood*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011247:Pregnancy; D012044:Regression Analysis; D014427:Twins; D055815:Young Adult
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain