Association between blood spot transforming growth factor-β and patent ductus arteriosus in extremely low-birth weight infants.

Academic Article

Abstract

  • Permanent ductal closure involves anatomic remodeling, in which transforming growth factor (TGF)-β appears to play a role. Our objective was to evaluate the relationship, if any, between blood spot TGF-β on day 3 and day 7 of life and patent ductus arteriosus (PDA) in extremely low birth weight (ELBW) infants. Prospective observational study involving ELBW infants (n = 968) in the National Institute of Child Health and Human Development Neonatal Research Network who had TGF-β measured on filter paper spot blood samples using a Luminex assay. Infants with a PDA (n = 493) were significantly more immature, had lower birth weights, and had higher rates of respiratory distress syndrome than those without PDA (n = 475). TGF-β on days 3 and 7 of life, respectively, were significantly lower among neonates with PDA (median 1,177 pg/ml [range 642-1,896]; median 1,386 pg/ml [range 868-1,913]) compared with others without PDA (median 1,334 pg/ml [range 760-2,064]; median 1,712 pg/ml [range 1,014-2,518 pg/ml]). The significant difference persisted when death or PDA was considered a composite outcome. TGF-β levels were not significantly different among subgroups of infants with PDA who were not treated (n = 51) versus those who were treated medically (n = 283) or by surgical ligation (n = 159). TGF-β was not a significant predictor of death or PDA (day 3 odds ratio [OR] 0.99, 95 % confidence interval [CI] 0.83-1.17; day 7 OR 0.88, 95 % CI 0.74-1.04) on adjusted analyses. Our results suggest that blood spot TGF-β alone is unlikely to be a reliable biomarker of a clinically significant PDA or its responsiveness to treatment.
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    Keywords

  • Ductus Arteriosus, Patent, Female, Humans, Infant, Infant, Extremely Low Birth Weight, Infant, Newborn, Male, Prospective Studies, Respiratory Distress Syndrome, Newborn, Transforming Growth Factor beta
  • Digital Object Identifier (doi)

    Author List

  • Natarajan G; Shankaran S; McDonald SA; Das A; Ehrenkranz RA; Goldberg RN; Stoll BJ; Tyson JE; Higgins RD; Schendel D
  • Start Page

  • 149
  • End Page

  • 154
  • Volume

  • 34
  • Issue

  • 1