Keywords
gestational hypertension
preeclampsia
NT-proBNP
endothelial dysfunction
How to Cite
Abstract
Introduction. Hypertensive disorders of pregnancy (HDP) are among the leading causes of maternal and perinatal morbidity and mortality. This necessitates improvement of early diagnostic and prognostic approaches. Impaired cardiovascular adaptation, increased vascular resistance, and endothelial dysfunction play key roles in their pathogenesis. N-terminal pro-brain natriuretic peptide (NT-proBNP), a biomarker reflecting myocardial hemodynamic load, appears promising; however, its prognostic value in gestational hypertension (GH) and preeclampsia (PE) remains to be fully established.
Aim. To evaluate the association between serum NT-proBNP levels and the development of HDP and to assess its prognostic potential.
Materials and methods. A total of 119 pregnant women were enrolled and divided into three groups: 61 women with HDP (46 with GH and 15 with moderate PE), 48 women at high risk of HDP, and 25 women with uncomplicated pregnancies (control group). All participants underwent clinical examination, 24-hour blood pressure (BP) monitoring, and serum NT-proBNP measurement using enzyme-linked immunosorbent assay. Statistical analysis was performed using Statistica 12 and MedCalc®.
Results. NT-proBNP levels were 3.4-fold higher in women with GH compared to controls (196.41 ± 17.28 vs. 56.16 ± 6.62 pg/mL, p = 0.000) and 4.7-fold higher in women with PE compared to controls (264.73 ± 9.13 vs. 56.16 ± 6.62 pg/mL, p = 0.000). NT-proBNP levels were 1.3-fold higher in PE compared to GH (p = 0.000). In the high-risk group, women who subsequently developed HDP had significantly higher NT-proBNP levels in the second trimester compared to controls (87.71 ± 8.56 vs. 56.16 ± 6.62 pg/mL, p = 0.006) and compared to women who remained normotensive (87.71 ± 8.56 vs. 62.79 ± 5.50 pg/mL, p = 0.018). A strong positive correlation was observed between NT-proBNP levels and mean daily systolic BP in women with HDP (r = 0.81, p = 0.000) and a moderate positive correlation in the high-risk group (r = 0.54, p = 0.000).
Conclusions. Elevated NT-proBNP levels are associated with HDP. NT-proBNP may serve as an informative biomarker for early detection, risk stratification, and clinical monitoring of patients with GH and PE.
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