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PEDIATRICS Vol. 112 No. 4 October 2003, pp. 896-899

Plasma Concentrations of Aminoterminal Pro Atrial Natriuretic Peptide and Aminoterminal Pro Brain Natriuretic Peptide in Healthy Neonates: Marked and Rapid Increase After Birth

Thomas S. Mir, MD*, Reinhard Laux, MD{ddagger}, Hans Henning Hellwege, MD§, Bozena Liedke, MD{ddagger}, Cornelius Heinze, MD{ddagger}, Helmut von Buelow, MD{ddagger}, Stephanie Läer, MD||, Jochen Weil, MD*

* Klinik und Poliklinik für Kinder- und Jugendmedizin, Abteilung für Kinderkardiologie, Universitätsklinikum Hamburg Eppendorf, Hamburg, Germany
{ddagger} Abteilung Neonatologie, Allgemeines Krankenhaus Barmbek, Hamburg, Germany
§ Klinik und Poliklinik für Kinder- und Jugendmedizin, Abteilung für Neonatologie und Paediatrische Intensivmedizin, Universitätsklinik Eppendorf, Hamburg, Germany
|| Institut für Experimentelle und Klinische Pharmakologie, Abteilung für Allgemeine Pharmakologie, Universitätsklinik Eppendorf, Hamburg, Germany

Objective. The purpose of the study was to examine the possible age dependency of plasma N-terminal pro atrial natriuretic peptide (N-ANP) and N-terminal pro brain natriuretic peptide (N-BNP) levels in healthy term neonates to establish normal ranges for the neonatal period.

Methods. N-ANP and N-BNP plasma concentrations were measured in peripheral venous (n = 116) and umbilical cord blood (n = 37) in 153 healthy term neonates (mean: 5.1; range: 0–30 days) using an enzyme immunoassay. The neonates were classified into 8 groups according to their age (day of delivery and 1, 2, 3, 4, 5–7, 8–14, and 14–30 days of age).

Results. The plasma N-ANP and N-BNP concentration were the highest at the first day of age (96 700; 6912–436 000 and 641; 254-1272 fmol/mL) and were found significantly higher compared with the day of delivery (5680; 1005–16 900 and 221; 58–478 fmol/mL; P < 0,0001). After this marked increase, N-ANP and N-BNP levels decreased steadily and became stable at the fifth (5232; 2691–7353 fmol/mL) and third (246; 110–430 fmol/mL) day of life, respectively.

Conclusions. The N-ANP and N-BNP plasma concentrations in healthy neonates showed a marked increase during the first days of age, suggesting that ANP and BNP have physiologic roles in the perinatal circulatory change from fetus to neonate.

Key Words: Nt pro ANP • Nt pro BNP • neonates • natriuretic peptides

Abbreviations: ANP, atrial natriuretic peptide • BNP, brain natriuretic peptide • N-ANP, N-terminal pro atrial natriuretic peptide • N-BNP, N-terminal pro brain natriuretic peptide

Received for publication Dec 12, 2002; Accepted Apr 8, 2003.


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