natriuretic-peptide--brain and Chorioamnionitis

This study aimed to determine the relationship between fetal exposure to intra-amniotic infection/inflammation (IAI) and fetal heart ventricular function as assessed by circulatory levels of N-terminal fragment brain natriuretic protein (NT-proBNP) and the Tei index.. We analyzed 70 samples of paired amniotic fluid (AF) and cord blood retrieved from mothers who delivered preterm at <34 weeks as follows: Yes-IAI (. IAI was characterized by significantly higher levels of AF (. Fetal myocardial left ventricular function does not seem to be significantly impaired in fetuses born alive due to IAI if delivery of the fetus occurs immediately following the diagnosis of IAI.

Topics: Adult; Amniocentesis; Amniotic Fluid; Biomarkers; Chorioamnionitis; Echocardiography, Doppler; Female; Fetal Blood; Fetal Heart; Humans; Infant, Newborn; Infant, Premature; Inflammation; Interleukin-6; Male; Mass Spectrometry; Natriuretic Peptide, Brain; Peptide Fragments; Placenta; Pregnancy; Premature Birth; Ventricular Function, Left

Although the B-type natriuretic peptide (BNP) levels in the umbilical cord blood (UCB-BNP) and amniotic fluid (AF-BNP) of neonates may be clinically useful for identifying newborns with cardiac dysfunction, the effects of various clinical factors, such as gestational age at birth, small for gestational age (SGA), and neonatal asphyxia, on the UCB-BNP and AF-BNP levels have not been studied extensively.. The present study sought to determine whether the UCB-BNP and AF-BNP levels can predict cardiac dysfunction and hypotension in preterm infants soon after birth and to evaluate the association between BNP and various clinical factors. The UCB-BNP and AF-BNP levels at birth were determined in 320 and 195 neonates, respectively, born to mothers with singleton pregnancies.. The UCB-BNP and AF-BNP levels in infants treated with dopamine were significantly higher than those in infants without dopamine administration (230.1 vs 33.1 pg/mL and 74.4 vs 18.1 pg/mL, respectively). Stepwise multiple regression analyses indicated that gestational age, SGA, asphyxia, and chorioamnionitis were significant independent determinants of the UCB-BNP level. Cut-off values of >90 pg/mL for UCB-BNP and >36 pg/mL for AF-BNP yielded sensitivities of 68% and 93%, respectively, and specificities of 84% and 81%, respectively, for detecting neonates who required dopamine administration after birth.. High UCB-BNP and AF-BNP levels predict neonatal cardiac dysfunction soon after birth.

Topics: Adult; Amniotic Fluid; Chorioamnionitis; Dopamine; Echocardiography; Female; Fetal Blood; Heart Diseases; Humans; Hypotension; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Male; Multivariate Analysis; Natriuretic Peptide, Brain; Pregnancy; Prospective Studies; Regression Analysis; Young Adult