B-type natriuretic peptide reference interval of newborns from healthy and pre-eclamptic women: a prospective, multicentre, cross-sectional study (original) (raw)
Related papers
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.
Annals of Palliative Medicine, 2021
Background: Elevated B-type natriuretic peptide (BNP) is closely related to preeclampsia. Whether it is a predictor of adverse outcomes in preeclampsia is unclear. This study aimed to investigate the relationship between BNP and adverse outcomes of preeclampsia, and to establish the prediction models and nomograms based on BNP. Methods: A retrospective analysis was conducted involving 284 women with preeclampsia admitted to a tertiary hospital from January 2017 to July 2019. Logistic regression and receiver operating characteristic (ROC) curve were used to analyze the relationship between BNP and adverse outcomes. Multivariate logistic regression was used to establish the models for predicting adverse outcomes. Then the nomogram and ROC curve of the models were generated. Results: In preeclampsia, BNP is a risk factor for adverse outcomes, and as the level of BNP increases, the incidence of adverse outcomes increases. Preeclampsia with BNP >118 pg/mL was associated with a significantly increased risk of adverse outcomes. The results showed that BNP has a predictive value for adverse maternal outcomes, and the area under the ROC curve (AUC) was 0.739 [P<0.001, 95% confidence interval (CI): 0.684-0.789]. Then, the prediction models for adverse maternal and perinatal outcomes based on BNP combined with other multi-factors were established. The discriminative ability of the 2 models was found to be good, the AUC was 0.844 (95% CI: 0.796-0.884) and 0.792 (95% CI: 0.740-0.838), respectively. Therefore, BNP was shown to significantly improve the discriminative ability of the prediction models. Conclusions: The BNP is an important risk factor for evaluating the adverse outcomes of preeclampsia.
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
Clinical Biochemistry, 2010
We aimed to investigate the range of fetal NT-proBNP values in normal pregnancy between 20 and 34 weeks of gestation. NT-proBNP was measured in 56 fetal blood samples. Mean (+ or - 2 SD) NT-proBNP concentration was 1998 (242-3754) ng/L; a significant decline occurred with advancing gestational age (p=0.012). Gestational age has to be taken in to consideration in the assessment of NT-proBNP. Our data may be used as reference values in fetal and neonatal medicine.
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 ...
Increased B-type natriuretic peptide levels in early-onset versus late-onset preeclampsia
Clinical Chemistry and Laboratory Medicine, 2000
Background: There is a variable tandem repeat polymorphism in the 5′-flanking region of the natriuretic peptide precursor B gene (NPPB). A previous study showed association of the (TTTC) small tandem repeat (STR) variants of this gene and essential hypertension. Our aim was to identify this polymorphism in samples of pre-eclamptic patients and healthy controls. We also compared the natriuretic peptide B (BNP) concentrations.
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.
American Journal of Obstetrics and Gynecology, 2000
OBJECTIVE: This study was done to evaluate left ventricular structure and function among pregnant patients with preeclampsia and compare them with those of normotensive pregnant and nonpregnant subjects. It also tested the hypothesis that abnormalities in left ventricular structure and function are associated with elevated plasma levels of natriuretic peptides. STUDY DESIGN: The study compared 75 pregnant women (n = 40 with preeclampsia; n = 35 normotensive pregnant women) and 10 nonpregnant normotensive control subjects undergoing an echocardiographic and biohumoral (renin activity and aldosterone, atrial natriuretic peptide, and brain natriuretic peptide concentrations) evaluation. The statistical analysis was carried out by analysis of variance, and significance was set at P < .05. RESULTS: Comparison of pregnant patients with preeclampsia versus both normotensive pregnant women and nonpregnant women showed significant increases in left ventricular mass and left ventricular endsystolic and end-diastolic volumes and significant reductions in left ventricular ejection fraction and percentage of fractional shortening. These changes coincided with increases in plasma levels of atrial natriuretic peptide and brain natriuretic peptide that were linearly related to the left ventricular structural and functional changes observed in patients with preeclampsia. CONCLUSION: Pregnant patients with preeclampsia showed adaptation to the increase in systemic blood pressure, with significant modification of left ventricular structure and function related to the plasma levels of both atrial natriuretic peptide and brain natriuretic peptide. A simple evaluation of plasma natriuretic peptide concentrations could help to discriminate patients with preeclampsia who have a condition of mild left ventricular overload. (Am J Obstet Gynecol 2000;183:140-7.)