Vasoactive peptides as biomarkers for the prediction of retinopathy of prematurity

Pediatr Res. 2024 Jun;95(7):1868-1874. doi: 10.1038/s41390-024-03091-w. Epub 2024 Feb 24.

Abstract

Background: Retinopathy of prematurity (ROP) is a major complication in preterm infants. We assessed if plasma levels of midregional pro-atrial natriuretic peptide (MR-proANP) and C-terminal pro-endothelin-1 (CT-proET1) serve as early markers for subsequent ROP development in preterm infants <32 weeks gestation.

Methods: Prospective, two-centre, observational cohort study. MR-proANP and CT-proET1 were measured on day seven of life. Associations with ROP ≥ stage II were investigated by univariable and multivariable logistic regression models.

Results: We included 224 infants born at median (IQR) 29.6 (27.1-30.8) weeks gestation and birth weight of 1160 (860-1435) g. Nineteen patients developed ROP ≥ stage II. MR-proANP and CT-proET1 levels were higher in these infants (median (IQR) 864 (659-1564) pmol/L and 348 (300-382) pmol/L, respectively) compared to infants without ROP (median (IQR) 299 (210-502) pmol/L and 196 (156-268) pmol/L, respectively; both P < 0.001). MR-proANP and CT-proET1 levels were significantly associated with ROP ≥ stage II in univariable logistic regression models and after adjusting for co-factors, including gestational age and birth weight z-score.

Conclusions: MR-proANP and CT-proET1 measured on day seven of life are strongly associated with ROP ≥ stage II in very preterm infants and might improve early prediction of ROP in the future.

Impact: Plasma levels of midregional pro-atrial natriuretic peptide and C-terminal pro-endothelin-1 measured on day seven of life in very preterm infants show a strong association with development of retinopathy of prematurity ≥ stage II. Both biomarkers have the potential to improve early prediction of retinopathy of prematurity. Vasoactive peptides might allow to reduce the proportion of screened infants substantially.

Publication types

  • Observational Study
  • Multicenter Study

MeSH terms

  • Atrial Natriuretic Factor* / blood
  • Biomarkers* / blood
  • Endothelin-1* / blood
  • Female
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infant, Premature / blood
  • Logistic Models
  • Male
  • Peptide Fragments / blood
  • Prospective Studies
  • Protein Precursors / blood
  • Retinopathy of Prematurity* / blood
  • Retinopathy of Prematurity* / diagnosis

Substances

  • Biomarkers
  • Atrial Natriuretic Factor
  • Endothelin-1
  • Peptide Fragments
  • C-terminal proendothelin-1
  • midregional pro-atrial natriuretic peptide, human
  • Protein Precursors