Reference values for N-terminal pro-B-type natriuretic peptide in fetal circulation between 20 and 34 weeks of gestation (original) (raw)
Related papers
Revista Brasileira de Ginecologia e Obstetrícia, 2016
Purpose The amniotic fluid volume (AFV) is known as a predictor for the wellness of a fetus. We aimed to investigate whether N-terminal pro-brain natriuretic peptide (NTproBNP) levels reflect AFV abnormalities in otherwise normal fetuses. Methods We recruited 24 women with isolated oligohydramnios, 23 women with isolated polyhydramnios, and 36 women with normal AFV at a tertiary referral center. NT-proBNP levels in umbilical venous samples and the individual characteristics of the three groups were compared. One-way ANOVA and Kruskal-Wallis analysis of variance were used for multi-group comparisons of continuous variables. When a significant difference was detected, the Scheffe test was performed as a post-hoc analysis. Proportions were compared using the Chi-square (2) test. Results Maternal age, body mass indices, weight gained in pregnancy and NT-proBNP levels were similar among the three groups. Apgar scores at 1 and 5 minutes significantly correlated with NT-proBNP levels in all newborns (Spearman's r ¼ 0.23; p ¼ 0.03 and Spearman's r ¼ 0.24; p ¼ 0.02, respectively). The umbilical venous NT-proBNP levels did not differ between newborns who needed mechanical ventilation and those who didn't (p ¼ 0.595). Conclusions NT-proBNP is a biomolecule that may provide insights into the pathogenesis of fetal circulatory problems and subsequent renal failure. Further investigations are warranted.
2016
Purpose The amniotic fluid volume (AFV) is known as a predictor for the wellness of a fetus. We aimed to investigate whether N-terminal pro-brain natriuretic peptide (NTproBNP) levels reflect AFV abnormalities in otherwise normal fetuses. Methods We recruited 24 women with isolated oligohydramnios, 23 women with isolated polyhydramnios, and 36 women with normal AFV at a tertiary referral center. NT-proBNP levels in umbilical venous samples and the individual characteristics of the three groups were compared. One-way ANOVA and Kruskal-Wallis analysis of variance were used for multi-group comparisons of continuous variables. When a significant difference was detected, the Scheffe test was performed as a post-hoc analysis. Proportions were compared using the Chi-square (2) test. Results Maternal age, body mass indices, weight gained in pregnancy and NT-proBNP levels were similar among the three groups. Apgar scores at 1 and 5 minutes significantly correlated with NT-proBNP levels in all newborns (Spearman's r ¼ 0.23; p ¼ 0.03 and Spearman's r ¼ 0.24; p ¼ 0.02, respectively). The umbilical venous NT-proBNP levels did not differ between newborns who needed mechanical ventilation and those who didn't (p ¼ 0.595). Conclusions NT-proBNP is a biomolecule that may provide insights into the pathogenesis of fetal circulatory problems and subsequent renal failure. Further investigations are warranted.
BMJ open, 2018
To define and compare the reference interval of B-type natriuretic peptide (BNP) in healthy newborns (HN) from healthy mothers and with severe pre-eclampsia. Prospective, multicentre, cross-sectional study. Four obstetric wards of second-level academic hospitals. 167 HN, from 146 healthy and 21 severe pre-eclamptic women. We included newborns from healthy mothers with full-term pregnancies (38 to 42 gestational weeks), who received adequate prenatal care and who had Apgar scores ≥7 at 0 and 5 min. Newborns with chromosomopathies identified during prenatal consultations, those with respiratory distress and those with cardiac or pulmonary disease detected in the first paediatric evaluation were excluded from this study. In the group of pre-eclamptic women, we considered the same inclusion criteria, but the patients also had to meet the diagnostic criteria for pre-eclampsia with severity features, according to the American College of Obstetricians and Gynaecologists guidelines. The sam...
European Journal of Pediatrics, 2020
The aim of our study was to observe the temporal distribution of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) in premature infants of ≤ 31 weeks of gestational age (GA) during the first weeks of life. NT-proBNP values of 118 preterm infants born ≤ 31 weeks GA were determined during the first week of life, after 4 ± 1 weeks of life, and at a corrected GA of 36 ± 2 weeks. Infants were divided into two groups: those without relevant complications and those with complications related to prematurity. NT-proBNP values of infants without complications define our exploratory reference values. The Median NT-proBNP level of these infants was 1896 ng/l (n = 27, interquartile range (IQR): 1277–5200) during the first week of life, 463 ng/l (n = 26, IQR: 364–704) at 4 ± 1 weeks of life, and 824 ng/l (n = 33, IQR: 714–1233) at a corrected GA of 36 ± 2 weeks. Infants born < 28 + 0 weeks GA had significantly higher NT-proBNP values (n = 9, median: 5200, IQR: 1750–8972) than infants ...
Longitudinal Changes in the B-Type Natriuretic Peptide Levels in Normal Pregnancy and Postpartum
Clinical Cardiology, 2009
Normal levels of B-type natriuretic peptide (BNP) are not well established in pregnancy. We obtained longitudinal BNP levels in 29 healthy pregnant women in each trimester and postpartum period, and compared these levels to the 25 nonpregnant controls. There were no significant differences among the cases and controls with respect to weight, diastolic blood pressure, and ethnicity. A total of 116 BNP values were obtained during pregnancy. The median (and range) BNP level during pregnancy was 19 (10-143) pg/ml versus 10 (10-37) pg/ml in the nonpregnant controls (p = 0.003). However, there were no statistically significant differences in the median BNP levels at various stages of pregnancy: first trimester 20 (10-115) pg/ml versus the second trimester 18 (10-112) pg/ml (p = 0.8), second trimester 18 pg/ml versus third trimester 26 (10-143) pg/ml (p = 0.06), and third trimester 26 pg/ml versus postpartum18 (10-62) pg/ml (p = 0.08). There were no significant differences between the BNP levels throughout the trimesters and postpartum period. Pregnant BNP levels were approximately twice as high as the nonpregnant BNP levels. Our study is unique in evaluating longitudinal changes in BNP levels in normal pregnancies and the postpartum period in comparison with healthy, nonpregnant controls. It demonstrates that pregnant BNP levels are approximately 2-fold higher than their nonpregnant counterparts, and do not significantly fluctuate during pregnancy. In conclusion, pregnancy is associated with a significant, but small increase in the BNP levels compared with nonpregnant women. . Normal, healthy, pregnant women in the first trimester of pregnancy were offered participation in the study. Subjects with significant medical history including cardiovascular disease, hypertension, pulmonary airway disease, pulmonary hypertension, and symptoms of shortness of breath were excluded from the study. A total of 25 nonpregnant female subjects E60
2021
Pregnancy yields physiologic changes to the cardiac circulatory system and alterations in volume status. Since serum NT-proBNP levels rise in response to cardiac ventricular myocyte stretch, it is not surprising that higher NT-proBNP levels are noted throughout pregnancy even in normotensive pregnancies versus non-pregnancy. Patients with hypertensive disorders of pregnancy have been shown to have higher NT-proBNP levels compared to normal pregnancy. We examined the NT-proBNP levels immediately before and after delivery in non hypertensive women and those with hypertensive gestational syndromes including chronic hypertension (cHTN), gestational hypertension (GH) and preeclampsia (PEC). A total of 97 patients were enrolled. Thirty-five normotensive controls, 14 in the cHTN group, 29 in the GH group and 19 in the PEC group. The mean antepartum NT-proBNP level in the normotensive control group was 65.4pg/dL, 82.1pg/dL in cHTN group, 64.8pg/dL in the GH group and 133.3pg/dL in the PEC g...
Bali Medical Journal, 2021
Background: Hypertension is the second most common cause of maternal death in the world. Predicting the occurrence of preeclampsia (PE) complications is needed to optimize management. Brain natriuretic peptide (BNP) is a polypeptide, secreted by cardiac ventricular myocytes. Research linking N-Terminal Pro B-Type Natriuretic Peptide (NT-proBNP) levels with maternal complications has never been conducted in Indonesia. The aim of the study is to evaluate plasma NT-proBNP levels in pregnant women with pre-eclampsia and normotension and to find a relationship between NT-proBNP levels and maternal complications incidence. Methods: This cross sectional study was conducted on thirty women with severe preeclampsia with gestational age >20 weeks who attended and underwent labor at Dr. Kariadi Hospital Semarang during study period. Patients with a history of chronic disease, underweight or obese, history of heart disease and consumption of heart drugs were excluded. Serum NT-proBNP was taken prior labor. Correlation between NT-proBNP serum levels and physical characteristics as well as complications was performed using the Mann-Whitney and Spearman correlation test. Results: NT-proBNP serum levels were significantly higher in the severe preeclampsia group, especially early-onset compared to the normotensive group (p<0.05). Increased serum NT-proBNP levels are associated with several maternal complications, especially HELLP syndrome, pulmonary edema, retinopathy and renal impairment. Conclusions: Increased serum NT-proBNP levels are associated with severe preeclampsia and several maternal complications.
Do N-Terminal Pro-C-Type Natriuretic Peptide Levels Relate to Severity of Preeclampsia?
International Journal of Hypertension, 2020
Aim. To compare the plasma N-terminal pro-C-type natriuretic peptide concentrations of normotensive pregnant women, patients with mild preeclampsia, and patients with severe preeclampsia. Methods. We collected venous blood samples from 25 normotensive pregnant women, 15 patients with mild preeclampsia, and 15 patients with severe preeclampsia. The women were at 30th to 40th weeks of gestation and in an age range of 20 to 35. The N-terminal pro-C-type natriuretic peptide levels were measured by ELISA. Statistical comparisons were made by one-way analysis of variance, Kruskal–Wallis, and Mann–Whitney U tests. Results. The median (interquartile range-IQR) values of the N-terminal pro-C-type natriuretic peptide were 6.48 (3.33) pmol/L in the normotensive women group, 7.37 (3.43) pmol/L in patients with mild preeclampsia, and 11.52 (6.13) pmol/L in patients with severe preeclampsia. The N-terminal pro-C-type natriuretic peptide was significantly elevated in the severe preeclampsia study ...
B-Type Natriuretic Peptide in Pregnant Women With Heart Disease
Journal of The American College of Cardiology, 2010
The objectives of this study were to examine: 1) B-type natriuretic peptide (BNP) response to pregnancy in women with heart disease; and 2) the relationship between BNP levels and adverse maternal cardiac events during pregnancy.Pregnancy imposes a hemodynamic stress on the heart. BNP might be a useful biomarker to assess the ability of the heart to adapt to the hemodynamic load of pregnancy.This was a prospective study of women with structural heart disease seen at our center. Serial clinical data and plasma BNP measurements were obtained during the first trimester, third trimester, and after delivery (>6 weeks).Seventy-eight pregnant women were studied; 66 women with heart disease (age 31 ± 5 years), and 12 healthy women (age 33 ± 5 years). During pregnancy, the median peak BNP level was higher in women with heart disease compared with control subjects (median 79, interquartile range 51 to 152 pg/ml vs. median 35, interquartile range 21 to 43 pg/ml, p < 0.001). In women with heart disease, those with subaortic ventricular dysfunction had higher BNP levels (p = 0.03). A BNP >100 pg/ml was measured in all women with events during pregnancy (n = 8). Sixteen women had increased BNP levels during pregnancy but did not have clinical events. None of the women with BNP ≤100 pg/ml had events. BNP ≤100 pg/ml had a negative predictive value of 100% for identifying events during pregnancy.Many pregnant women with heart disease have increased BNP levels during pregnancy. Incorporating serial BNP levels in into clinical practice can be helpful, specifically in adjudicating suspected adverse cardiac events during pregnancy.