Retinopathy of prematurity screening at ≥30 weeks: urinary NTpro-BNP performance

Area of Science:

• Neonatal ophthalmology
• Biomarker research
• Perinatal medicine

Background:

• Urinary N-terminal B-type natriuretic peptide (NTproBNP) is linked to retinopathy of prematurity (ROP) in premature infants (<30 weeks gestation).
• ROP incidence is low in more mature infants meeting screening criteria.
• Predictive biomarkers for ROP in this subgroup are needed.

Purpose of the Study:

• To investigate if urinary NTproBNP levels can predict ROP development in infants born at or after 30 weeks gestation.
• To determine the utility of urinary NTproBNP as a screening tool for ROP in a specific cohort of preterm infants.

Main Methods:

• Prospective observational study of 151 UK infants (≥30 + 0 and <32 weeks gestation and/or <1501 g).
• Urinary NTproBNP levels measured on day of life 14 and day 28.
• Correlation of NTproBNP levels with ROP development.

Main Results:

• No significant difference in urinary NTproBNP concentrations on DOL 14 (median 144 vs 128 mcg/mL, p=0.86) or DOL 28 (median 117 vs 94 mcg/mL, p=0.64) between infants with and without ROP.
• The previously observed association between urinary NTproBNP and ROP in younger infants was not replicated.

Conclusions:

• Urinary NTproBNP is not a reliable predictor of ROP in preterm infants born at or after 30 weeks gestation.
• The findings suggest urinary NTproBNP may not aid in optimizing ophthalmoscopic screening for ROP in this population.
• A potential difference in ROP pathophysiology between preterm infants <30 weeks and those ≥30 weeks is indicated.