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Updated: Jun 12, 2026
Transcutaneous Microcirculatory Imaging in Preterm Neonates
Published on: December 31, 2015
BNP concentrations and cardiovascular adaptation in preterm and fullterm newborn infants
Savina Mannarino1, Francesca Garofoli, Elisa Mongini
1Pediatric Cardiology, Department of Paediatrics, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy.
Insights
Newborns
Area of Science:
- Neonatal Cardiology
- Pediatric Cardiovascular Physiology
Background:
- Cardiovascular adaptation is critical for preterm and fullterm newborns transitioning to extrauterine life.
- Brain Natriuretic Peptide (BNP) and echocardiography are key tools for assessing neonatal cardiac function.
Purpose of the Study:
- To compare cardiovascular adaptation in preterm and fullterm newborns.
- To analyze the impact of Patent Ductus Arteriosus (PDA) on cardiovascular adaptation.
- To investigate the relationship between BNP levels and echocardiographic parameters.
Main Methods:
- Analysis of BNP concentration and echocardiographic parameters in 36 preterm and 34 fullterm newborns at day 3 and day 28 of life.
- Comparison of BNP levels and echocardiographic findings between preterm with PDA, preterm without PDA, and fullterm neonates.
- Correlation analysis between BNP and echocardiographic parameters.
Main Results:
- On day 3, BNP levels were significantly higher in preterm infants with PDA compared to preterm infants without PDA and fullterm infants.
- No significant differences in BNP levels were observed among the groups at day 28.
- Echocardiographic parameters showed a linear relationship with body weight in all groups.
- BNP correlated with Left Atrium to Aorta ratio (LA/AO) in preterm infants with PDA on day 3.
- On day 28, BNP correlated with mitral valve inflow velocity-time integral (mVTI), M-mode parameters (M), and Left Atrium (LA) in fullterm infants, and only with LA in preterm infants.
Conclusions:
- Preterm and fullterm newborns exhibit similar cardiovascular adaptation during the transition to postnatal circulation, with BNP levels normalizing by one month of age.
- The presence of PDA in the initial days of life does not significantly impact this adaptation process.
- Left Atrium (LA) size is the echocardiographic parameter most consistently related to BNP concentration in newborns.
Abstract:
To evaluate and compare cardiovascular adaptation of 36 preterm and 34 fullterm newborns, we analyzed BNP concentration and echocardiographic parameters at day 3 of life and at day 28 (+/-2). On day 3 BNP concentrations (pg/ml) resulted higher in PDA preterm group (n=11; 125, IQR 56.1-301) than preterm without PDA (n=25; 25.5 IQR 10.9-49; p<0.001) than fullterms (n=34; 55.1 IQR 23.6-82.7; p=0.013). No difference resulted in all groups at 28days (respectively: 12.7 IQR 4.9-23.8; 15.6 IQR 10-22; 8.9 IQR 5.6-20.6). Because of the newborns' growth, all echocardiographic parameters increased with linear relationship with body weight. On day 3 BNP concentration and echocardiographic parameters were not correlated besides LA/AO in preterms with PDA (p=0.0015). On day 28, BNP was significantly correlated with mVTI (p=0.019), M (p=0.007) and LA (p=0.005) in fullterms and only with LA (p=0.007) in preterms. In conclusion, BNP concentrations and echocardiographic measures confirm that preterm, and fullterm newborns conduct themselves in a similar manner during the transition from foetal to post-natal circulation, reaching low levels at a month of life. The presence of PDA during first days of life has no significant impact in this adaptation. LA is the echocardiographic parameter mostly related to BNP concentration in the newborns.
