Prenatal Clinical Assessment of NT-proBNP as a Diagnostic Tool for Preeclampsia, Gestational Hypertension and Gestational Diabetes Mellitus

Abstract

Common complications of pregnancy include preeclampsia (PE), gestational hypertension (GH) and gestational diabetes mellitus (GDM). Hypertensive disorders (PE/GH) and GDM may result in greater maternal, fetal and neonatal morbidity and mortality. Women with PE/GH, one of the most common causes of heart burden in an obstetrical setting, present with elevated serum levels of BNP and NT-proBNP. The aim of this study was to shed more light on the role of NT-proBNP in pathophysiology of PE, GH and GDM. The study included 156 pregnant women with singleton pregnancies. A total of 26 women developed arterial hypertension during pregnancy, 14 were diagnosed with PE, and GDM was detected in 81 patients. The control group included 35 women with uncomplicated pregnancies, normal arterial blood pressure and normal glucose concentrations. Patients with GH presented with significantly higher serum concentrations of NT-proBNPthan normotensive women (65.5 vs. 37.4 pg/ml; p = 0.0136). Serum levels of NT-proBNP in patients with PE were the highest of all the analyzed subsets, being significantly higher than in women without this condition (89.00 vs. 37.4pg/ml,p = 0,0136). However, women with and without GDM did not differ significantly in terms of their serum NT-proBNPconcentrations. Serum NT-proBNP (pg/ml) (p = 0.0001) and BMI (p<0.0001) turned out to be independent predictors of GH on multivariate logistic regression analysis.Moreover, serum NT-proBNP (pg/ml) was identified as an independent indicator of PE (p = 0.0016). A significant inverse correlation was found between birth weight and maternal serum NT-proBNP concentrations. In our opinion, NT-proBNP can be a useful clinical marker of GH and PE. Determination of NT-proBNP levels may be helpful in identification of patients with PE and GH and in their qualification for intensive treatment; this in turn, may be reflected by better neonatal outcomes.

Assessment of Left Ventricular Functions in Hypertensive Diabetic Patients by Speckle Tracking Imaging: Correlation with Brain Natriuretic Peptide Levels

“…But the current findings were consistent with the ones from Sadlecki et al [50], who stated that even though usually BNP levels are higher in pregnant women than in nonpregnant ones, the subjects recruited in his study showed that levels of BNP were significantly higher in pregnant women with gestational hypertension than normotensive pregnant ones. Current findings were also in line with findings from Hamed et al [40], who revealed that BNP levels were significantly higher among hypertensive patients compared to control subjects.…”

RETRACTED: Polysaccharide IV from Lycium barbarum L. Improves Lipid Profiles of Gestational Diabetes Mellitus of Pregnancy by Upregulating ABCA1 and Downregulating Sterol Regulatory Element-Binding Transcription 1 via miR-33

“…Previous study showed that the cumulative incidence of type 2 diabetes mellitus was 6 weeks to 28 years in postpartum women with GDM ( 5 ). GDM has negative effects on future generations, including neonatal death ( 6 ), stillbirth ( 7 ), perinatal mortality ( 8 ), preeclampsia ( 9 ), large fetus ( 10 ), neonatal jaundice ( 11 ), low blood sugar ( 12 ), low calcium ( 13 ), and so on. However, the pathogenesis of GDM is still not fully understood.…”

Early-onset preeclampsia predisposes to preclinical diastolic left ventricular dysfunction in the fifth decade of life: An observational study

“…These findings were subsequently implemented with evidence of diastolic LV dysfunction[ 18 – 20 ] and worse myocardial strain on speckle tracking echocardiograms[ 21 ]. Findings during pregnancy were more severe in early onset preeclampsia than in term preeclampsia[ 22 ] and paralleled by increases in plasma natriuretic peptide levels[ 17 , 18 , 23 ]. Postpartum persistence of these abnormalities as preclinical LV dysfunction or LV hypertrophy remains unclear.…”