Usefulness of serum brain natriuretic peptide level for screening hemodynamically significant patent ductus arteriosus in preterm neonates

We studied usefulness of serum B-type natriuretic peptide level as a screening tool for detecting
hemodynamically significant patent ductus arteriosus in the preterm neonates.
Methods: Sixty admitted preterm neonates with gestational age ≤34 weeks, birth weight ≤2500 gr, and age of
>3 days have been enrolled in this study. We measured serum B-type natriuretic peptide levels at the
beginning and after completion of drug therapy for ductus occlusion.
Findings: Mean±SD gestational age and weight was 31±1.9 weeks and 1680±350 gr, respectively. The peptide
levels in the neonates with significant duct (n=13) were significantly higher than in those with insignificant
duct (n=17) or no duct (n=30) (1667±821 pg/ml versus 667±666 and 309±171, respectively). The peptide
level dropped significantly after ibuprofen administration in the neonates with significant PDA (n=13),
(1667±1165 pg/ml to 429±386).
Conclusion: At a cutoff point of 450 pg/ml, B-type natriuretic peptide level had a sensitivity of 92% and
specificity of 87%, the negative predictive value of 98.5%, the positive likelihood ratio of 6.92 and the
negative likelihood ratio of 0.089 for detecting significant patent duct. Levels below this can eliminate the
need for echocardiography.