Serum NT-proBNP as a predictive biomarker for bronchopulmonary dysplasia and mortality in preterm infants with patent ductus arteriosus: A prospective validation study

Abstract

Background Bronchopulmonary dysplasia (BPD) remains one of the most common and serious complications of premature birth, often leading to long-term morbidities. It affects approximately 40–50% of infants born before 29 weeks of gestation. Purpose Our study was designed to validate the useful predictive value of serum NT-proBNP for BPD/Death in preterm neonates born <32 weeks of gestation with patent ductus arteriosus (PDA), in an Egyptian dual-center NICU setting. Methods Preterm neonates (<32 weeks, <72 h of age), regardless of PDA status, were prospectively enrolled. Echocardiographic assessment of PDA, including ductal diameter, was performed. NT-proBNP levels were measured twice during the first 10 days of life (within 72 hours and on days 8–9). At 36 weeks postmenstrual age, infants were classified into BPD/death (n = 44) or survival without BPD ( n = 36). Results NT-proBNP levels measured within 72 hours and on days 8–9 showed a moderate predictive value for BPD/death in infants with PDA diameter >1.5 mm. At <72 hours, the sensitivity was 62.8% and the specificity was 83.3%. At days 8–9, the sensitivity increased to 72.7% and the specificity to 88.9%. Conclusion Serum NT-proBNP concentrations showed a moderate predictive value, with superior performance at days 8–9 of life for the development of BPD/death in preterm infants, regardless of persistence of PDA.