Association between blood spot transforming growth factor-β and patent ductus arteriosus in extremely low-birth weight infants

Girija Natarajan, Seetha Shankaran, Scott A. McDonald, Abhik Das, Richard A. Ehrenkranz, Ronald N. Goldberg, Barbara J. Stoll, Jon E. Tyson, Rosemary D. Higgins, Diana Schendel, David M. Hougaard, Kristin Skogstrand, Poul Thorsen, Waldemar A. Carlo

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Permanent ductal closure involves anatomic remodeling, in which transforming growth factor (TGF)-β appears to play a role. Our objective was to evaluate the relationship, if any, between blood spot TGF-β 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-β 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-β 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-β 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-β 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-β alone is unlikely to be a reliable biomarker of a clinically significant PDA or its responsiveness to treatment.

Original languageEnglish
Pages (from-to)149-154
Number of pages6
JournalPediatric Cardiology
Issue number1
StatePublished - Jan 2013


  • Neonate
  • Patent ductus arteriosus
  • Preterm
  • Transforming growth factor


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