Background and aims The N-terminal pro-brain natriuretic peptide (NTpro-BNP) is used to differentiate congestive heart failure and lung disease in children and adults. The aim of our study was to determine its utility in the assessment of respiratory distress (RD) in term neonates. We sought to find out whether it can distinguish cardiac from pulmonary aetiology of respiratory distress in term neonates.
Methods The NT pro-BNP level was determined in 60 neonates admitted for RD. They were further divided in two subgroups: 37 with congenital heart disease (CHD) and 23 with pulmonary disease. The control group consisted of 30 neonates with no signs of RD. Findings of auscultation, chest radiography, Silverman score and echocardiography were recorded for each patient. Blood samples for determining NT pro-BNP levels were obtained on admission, when blood sampling was indicated for the clinical management of the newborn.
Results The RD group, regardless of aetiology, showed significantly higher levels of NT- pro BNP than the control group (p < 0.001). Neonates with more severe RD had significantly higher level of NT-pro BNP (p = 0.002). No significant difference was found between neonates with RD due to CHD and those with RD due to pulmonary disease.
Conclusions Term neonates with RD have significantly higher NT-pro BNP levels than healthy neonates. Higher level of NTpro-BNP indicates more severe RD. A single measurement of NT pro-BNP leve lcannot be used as the sole biomarker for distinguishing between cardiogenic and noncardiogenic aetiology of RD in term neonates.