Retinopathy of prematurity screening at ≥30 weeks: urinary NTpro-BNP performance

Aim Urinary N-terminal B-type natriuretic peptide NTproBNP levels are associated with the development of retinopathy of prematurity (ROP) in infants <30 weeks gestation. The incidence of ROP in more mature infants who meet other ROP screening criteria is very low. We therefore aimed to test whether urinary NTproBNP predicted ROP development in these infants.MethodsProspective observational study in 151 UK infants ≥30+0 weeks gestation but also <32 weeks gestation and/or <1501g, to test the hypothesis that urinary NTproBNP levels on day of life (DOL) 14 and 28 were able to predict ROP development. ResultsUrinary NTproBNP concentrations on day 14 and day 28 of life did not differ between infants with and without ROP (medians 144mcg/ml vs 128mcg/ml respectively, p=0.44 on DOL 14 and medians 117mcg/ml vs 94mcg/ml respectively on DOL28). ConclusionThe association previously shown for infants <30 completed weeks between urinary NTproBNP and development of ROP was not seen in more mature infants. Urinary NTproBNP does not appear helpful in rationalizing direct ophthalmoscopic screening for ROP in more mature infants, and may suggest a difference in pathophysiology of ROP in this population.