Publication Date

1-1-2024

Journal

Neonatology

DOI

10.1159/000533824

PMID

37899032

Abstract

Background: Echocardiography is the gold standard for the diagnosis hemodynamically significant-patent ductus arteriosus (hs-PDA). It requires trained personnel and is not readily available. Urinary biomarkers can be used as an adjunct.

Objective: The objective of this study was to systematically review the diagnostic accuracy of urinary N terminal pro-B type natriuretic peptides (NT-proBNP) for hs-PDA in preterm neonates.

Methods: We included studies that evaluated urinary NT-proBNP and urinary NT-proBNP/creatinine ratio (index tests) in preterm neonates with hs-PDA (participants) in comparison with echocardiogram (reference standard). Methodological quality and certainty of evidence were assessed using Quality Assessment of Diagnostic-Accuracy Studies (QUADAS-2) and Grading of Recommendations Assessment, Development and Evaluation (GRADE), respectively.

Results: Low quality of evidence suggests that urinary NT-proBNP has modest sensitivity and specificity for the diagnosis of a hs-PDA, with variation in accuracy based on assay and patient characteristics.

Conclusion: Urinary NT-proBNP assays must be locally validated for specific patient populations and further studies to support its use must be performed.

Keywords

Humans, Infant, Infant, Newborn, Biomarkers, Ductus Arteriosus, Patent, Infant, Premature, Natriuretic Peptide, Brain, Peptide Fragments, Echocardiography, Natriuretic peptides, Neonates, Patent ductus arteriosus, Urinary biomarker

Published Open-Access

yes

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