Cord Blood Procalcitonin and N-terminal Pro-brain Natriuretic Peptide: Biomarkers for Early Prediction of Bronchopulmonary Dysplasia

Abstract

Abstract Background: This study focused on determining whether cord blood procalcitonin (PCT) and N-terminal pro-brain natriuretic peptide (NT-proBNP) concentrations could accurately predict bronchopulmonary dysplasia (BPD) in preterm infants. Methods: Overall, 452 preterm infants were included in this prospective cohort trial and were divided into groups according to their BPD diagnoses. We evaluated PCT and NT-proBNP concentrations in cord blood. The effectiveness of determining cord blood PCT and NT-proBNP concentrations in predicting BPD was assessed using the receiver operating characteristic curve analysis. Multivariable logistic regression analyses and mediation analyses were used to analyze the risk variables for BPD and the associations of the two biomarkers with perinatal factors and neonatal outcomes. Results: Concentrations of the two biomarkers were greater in the cord blood of preterm infants with BPD than in the No-BPD group (P < 0.001). The appropriate cutoff values for cord blood PCT and NT-proBNP to predict BPD were 0.28 ng/mL and 2,460.50 pg/mL, respectively. In the multivariable logistic regression analysis, fetal inflammatory response syndrome (FIRS), respiratory distress syndrome, and the two cord blood biomarker levels were identified as significant risk factors for BPD (odds ratio [OR] = 1.55–3.72). The concentration of cord blood PCT accounted for 26.4% and 34.6% of the association between FIRS and chorioamnionitis with BPD, respectively. The two cord blood biomarkers were found to be strongly associated with the incidence of neonatal outcomes (OR = 1.27–2.58). Conclusions: Cord blood PCT and NT-proBNP concentrations may be valuable noninvasive predictive indicators of BPD development in preterm newborns. Trial registration: This study was registered on the website http://www.chictr.org.cn/listbycreater.aspx (number ChiCTR2100052175).