Association between blood spot transforming growth factor-beta and patent ductus arteriosus in extremely low-birth weight infants
Permanent ductal closure involves anatomic remodeling, in which transforming growth factor (TGF)-beta appears to play a role. Our objective was to evaluate the relationship, if any, between blood spot TGF-beta 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-beta 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-beta 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-beta 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-beta 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-beta alone is unlikely to be a reliable biomarker of a clinically significant PDA or its responsiveness to treatment.
Natarajan, G., Shankaran, S., McDonald, S., Das, A., Ehrenkranz, R. A., Goldberg, R. N., ... Carlo, W. A. (2013). Association between blood spot transforming growth factor-beta and patent ductus arteriosus in extremely low-birth weight infants. Pediatric Cardiology, 34(1), 149-154. DOI: 10.1007/s00246-012-0404-7