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Serum N-Terminal Pro B-Type Natriuretic Peptide is associated with maternal complication in pregnancy with severe preeclampsia

  • Alini Hafiz ,
  • Julian Dewantiningrum ,
  • Herman Kristanto ,
  • M. Besari Adi Pramono ,


Abstract

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.

Keywords: preeclampsia NT-proBNP maternal complications

References

  1. Adu-Bonsaffoh K, Obed SA, Seffah JD. Maternal outcomes of hypertensive disorders in pregnancy at Korle Bu Teaching Hospital, Ghana. Int J Gynaecol Obstet. 2014;127(3):238–42.
  2. Wibowo N, Irwinda R, Frisdiantiny E, Karkata MK, Mose JC, Chalid MT, et al. National guidelines for the diagnosis and management of preeclampsia. Jakarta: POGI HKFM; 2016. p. 6–8.
  3. Zhou Y, Wu Q. Role of corin and atrial natriuretic peptide in preeclampsia. Placenta. 2013;34(2):89–94.
  4. Dave A, Maru L, Jain A. LDH (Lactate Dehydrogenase): a biochemical marker for the prediction of adverse outcomes in pre-eclampsia and eclampsia. J Obstet Gynaecol India. 2016;66(1):23–9.
  5. Mumtaz F, Memon AR, Yousfani S, Tahir SM, Khushk I, Memon M, et al. Role of serum leptin level as a marker of severity of preeclampsia. J Ayub Med Coll Abbottabad. 2008;20(1):13–5.
  6. Spencer K, Cowans NJ, Chefetz I, Tal J, Meiri H. First-trimester maternal serum PP- 13, PAPP-A and second-trimester uterine artery Doppler pulsatility index as markers of pre-eclampsia. Ultrasound Obstet Gynecol. 2007;29(2):128–34.
  7. Spencer K, Cowans NJ, Nicolaides KH. Maternal serum inhibin-A and activin-A levels in the first trimester of pregnancies developing pre-eclampsia. Ultrasound Obstet Gynecol. 2008;32(5):622–6.
  8. Kristensen K, Wide-Swensson D, Cshmidt C, Blirup-Jensen S, Lindström V, Strevens H, et al. Cystatin C, beta-2-microglobulin and beta-trace protein in pre-eclampsia. Acta Obstet Gynecol Csand. 2007;86(8):921–6.
  9. Stepan H, Herraiz I, Cshlembach D, Verlohren S, Brennecke S, Chantraine, et al. Implementation of the sFlt-1/PlGF ratio for prediction and diagnosis of pre-eclampsia in singleton pregnancy: implications for clinical practice. Ultrasound Obstet Gynecol. 2015;45:241–6.
  10. Kumari S, Gupta M, Vardhan H, Saini V, Gupta SK. NT-proBNP: A biochemical marker of maternal complications in pre-eclampsia. J Clin Diagnostic Res. 2017;11(11):QC12–6.
  11. Weber M, Hamm C. Role of B-type natriuretic peptide (BNP) and NT-proBNP in clinical routine. Heart. 2006;92(6):843–9.
  12. Fazlinezhad A, Rezaeian MK, Yousefzadeh H, Ghaffarzadegan K, Khajedaluee M. Plasma Brain Natriuretic Peptide (BNP) as an indicator of left ventricular function, early outcome and mechanical complications after acute myocardial infarction. Clin Med Insights Cardiol. 2011;5:77–83.
  13. Tyas BD, Lestari P, Akbar MI. Maternal Perinatal Outcomes Related to Advanced Maternal Age in Preeclampsia Pregnant Women. Journal of Family & Reproductive Health. 2019;13(4):191.
  14. Bdolah Y, Elchalal U, Natanson-Yaron S, Yechiam H, Bdolah-Abram T, Greenfield C, Goldman-Wohl D, Milwidsky A, Rana S, Karumanchi SA, Yagel S. Relationship between nulliparity and preeclampsia may be explained by altered circulating soluble fms-like tyrosine kinase 1. Hypertension in pregnancy. 2014;33(2):250-9.
  15. Yamada T, Koyama T, Furuta I, Takeda M, Nishida R, Yamada T, Morikawa M, Minakami H. Effects of caesarean section on serum levels of NTâ€pro BNP. Clinical endocrinology. 2013;78(3):460-5.
  16. Seong WJ, Kim CS, Hong DG, Koo TB, Park IS. Amino-terminal pro-brain natriuretic peptide levels in hypertensive disorders complicating pregnancy. Hypertens Pregnancy. 2011;30(3):287-94.
  17. Rafik Hamad R, Larsson A, Pernow J, et al. Assessment of left ventricular structure and function in preeclampsia by echocardiography and cardiovascular biomarkers. J Hypertens. 2009;27:2257–64.

How to Cite

Hafiz, A., Dewantiningrum, J., Kristanto, H., & Pramono, M. B. A. (2021). Serum N-Terminal Pro B-Type Natriuretic Peptide is associated with maternal complication in pregnancy with severe preeclampsia. Bali Medical Journal, 10(1), 304–308. https://doi.org/10.15562/bmj.v10i1.2162
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Alini Hafiz
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Julian Dewantiningrum
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Herman Kristanto
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M. Besari Adi Pramono
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