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

BackgroundBronchopulmonary 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.PurposeOur 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.MethodsPreterm 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).ResultsNT-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%.ConclusionSerum 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.