Reference values for plasma B-type natriuretic peptide in the first days of life.

The clinical relevance of B-type natriuretic peptide (BNP)1 and the amino terminal fragment of its prohormone (NT-proBNP) as biomarkers in pediatric heart disease have recently been shown (1)(2). BNP and NT-proBNP concentrations are dependent on age and sex, at least in adults(3). Because commercial methods are affected differently by the presence in plasma of several peptides derived from the degradation of intact prohormone and BNP(3), little if any agreement exists among reported reference intervals, especially those used for infants during the first days of extrauterine life(1). Data are scarce regarding the reference values for BNP and NT-proBNP in infancy (1)(2)(4). Recently, Nir et al.(2) summarized NT-proBNP concentrations measured with an electrochemiluminescence immunoassay method in 690 healthy individuals (47% males) with ages ranging from birth to 18 years, including 127 newborns in the first week of life (43 in the first 2 days). The NT-proBNP concentrations were highest in the first days of life, and then showed a marked decline. Concentrations in males and females differed only for children age 10–14 years. Large reference value studies for BNP for newborns and infants have …