Association of serum N-terminal pro-brain natriuretic peptide levels with the severity of preeclampsia

Bakacak, Murat; Serin, Salih; Ercan, Önder; Köstü, Bülent; Bakacak, Zeyneb; Kıran, Hakan

doi:10.3109/14767058.2015.1104663

Cited by 16 publications

(23 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This observation was similar to Murat Bakacak et al, Kumari S et al who also found NT-pro-BNP levels significantly higher in severe preeclampsia group compared with mild preeclampsia group (p < 0.001). 24,25 At 3 months postpartum resolution of NT-pro-BNP in both the groups was found to be complete. Persistent serum NT-pro-BNP was observed in eight women at the end of 6 weeks in group B.…”

Section: Discussionmentioning

confidence: 89%

“…Our results are comparable with study by Berks, et al (2009) who reported persistent postpartum proteinuria in 21% at 6 weeks and 14% of women at 3 months. 24 They followed patients till 2 years and finally at 2 years, 2 % had persistent proteinuria. They have reported resolution time increased by 16% (p = .001) for every 1-g/d increase in maximal proteinuria.…”

Section: Discussionmentioning

confidence: 99%

“…Plasma NT-pro-BNP measurement was done using Roche CARDIAC pro-BNP kit using cobas h 232 instrument in heparinized venous blood. 24 It is an immunoassay test using gold-labeled antibodies against NT-pro-BNP which form a sandwich complex with it, in the blood. The sandwich complexes thus formed, gives a visual signal as a red line, the intensity of which is converted to a quantitative result which is read in the display.…”

Section: Exclusion Criteriamentioning

confidence: 99%

See 2 more Smart Citations

Preeclampsia: Postpartum Resolution of Hypertension, Proteinuria and Serum N-terminal B-type Natriuretic Peptide

Gupta¹,

Gupta²,

Saini³

et al. 2019

Indian Journal of Medical Biochemistry

View full text Add to dashboard Cite

Background: Postpartum persistent proteinuria and hypertension (HT) is associated with development of chronic kidney disease and cardiovascular disease in later life. AIMS & OBJECTIVES: To evaluate blood pressure, proteinuria and serum NT-pro-BNP in proteinuric preeclamptic (PE) women and study their postpartum resolution till 3 months and determine the associated risk factors. Material and methods: 100 PE women enrolled included 66 women with mild (group A) and 34 with severe PE (group B). BP, urinary protein:creatinine(P/C) ratio, S.NT-pro-BNP were evaluated at labor room admission, postpartum day 1, 6 weeks and 3 months. Results: Group B women had significant higher baseline BP, urine P/C ratio and S. NT-pro-BNP compared to group A. Resolution of BP, proteinuria and S. NT-pro-BNP was complete in group A women at 6 weeks postpartum. Persistent hypertension was observed in 25 and 4 women at postpartum 6 weeks and 3 months respectively. Proteinuria persisted in 25 and 10 women at postpartum 6 weeks and 3 months respectively. Resolution of NT-pro-BNP was complete at 3 months. In logistic regression model persisting hypertension and proteinuria at 3 months was correlated with increasing age, higher BMI and lower gestational age at delivery. Negative predictive value of 100% was observed with baseline P/C ratio <5, BP <120 mm Hg diastolic and S.NT-pro-BNP <1000 pg/mL for development of persistent proteinuria and hypertension. Conclusion: Women with severe PE should be followed up for persistent proteinuria and hypertension. These women require evaluation for chronic kidney disease and preventive strategies for cardiovascular disease.

show abstract

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Exclusion Criteriamentioning

confidence: 99%

See 1 more Smart Citation

Preeclampsia: Postpartum Resolution of Hypertension, Proteinuria and Serum N-terminal B-type Natriuretic Peptide

Gupta¹,

Gupta²,

Saini³

et al. 2019

Indian Journal of Medical Biochemistry

View full text Add to dashboard Cite

show abstract

“…Our results indicate a partially better sensitivity and specificity for BNP in comparison with NT-proBNP, which is consistent with the results reported by Hill et al who compared the diagnostic accuracy of these biomarkers for the diagnosis of heart failure in the emergency department [37]. Some of the included studies Table 2 Meta-analysis of accuracy of N-terminal pro-brain-type natriuretic peptide for diagnosing cardiac complications in pregnancy AUC-SROC Area under the curve-summary receiver operating characteristic curve, CI confidence interval, DOR diagnostic odds ratio, NLR negative likelihood ratio, NPV negative predictive value, PLR positivie likelihood ratio, PPV positive predictive value indicated that when interpreting BNP levels in patients with pre-eclampsia, it is important to consider that BNP levels can be increased by hypertension, even if there are no signs of cardiac failure [23,34,39,40]. However, it has been suggested that the increase in BNP level is clinically dependent on the degree of clinical and non-clinically detectable ventricular abnormalities and the inherited state of preeclampsia [34,38].…”

Section: Discussionmentioning

confidence: 99%

Cardiac Complications in Pregnancy: A Systematic Review and Meta-Analysis of Diagnostic Accuracy of BNP and N-Terminal Pro-BNP

et al. 2021

View full text Add to dashboard Cite

Introduction: Serum brain-type natriuretic peptide (BNP) levels may be involved in detecting the breakdown of defense mechanisms in pregnant women. BNP and N-terminal pro-BNP (NT-proBNP) levels can be used in emergency settings as a biomarker to rule out or confirm cardiac complications. The present study was conducted as an attempt to evaluate the performance of BNP and NT-proBNP as diagnostic tools for cardiac complications, including heart failure and pre-eclampsia, in pregnant and recently-delivered women. Methods: This meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. To extract the data, articles meeting the inclusion criteria were directly reviewed by two of the authors. Disputes were resolved through discussion with all authors before data mining. In cases of unresolved disagreement, a third reviewer was consulted to achieve consensus. A quantitative analysis of the total bias of publications was performed using Stata software version 14.0, using funnel plots and Deek's test. Results: Overall, 13 unique studies were included in this review. The pooled sensitivity, specificity and positive and negative predictive values for diagnosing cardiac complications in pregnant women when BNP level was B 100 ng/ L, were determined to be 95, 62, 71 and 91%, respectively. The corresponding measures when the BNP levels were 100-500 ng/L were calculated to be 98, 92, 97 and 92%, respectively. The pooled sensitivity, specificity and positive and negative predictive values for diagnosing cardiac complications in pregnant women using NT-proBNP were 78, 74, 20.5 and 97%, respectively. Conclusion: Our results suggest that both BNP and NT-proBNP levels can be used as diagnostic tools among pregnant and newly-delivered women to diagnose cardiac complications, including heart failure and pre-eclampsia. While BNP showed a relatively better diagnostic accuracy compared to NT-proBNP, it must be noted that the number of studies evaluating NT-proBNP included in this meta-analysis was low and the studies were inconsistent in terms of cutoff value. Further studies are required to confirm the prospective use of BNP and NT-pro BNP in assessing common symptoms that indicate cardiac complications during labor. Moreover, the clinical use of the NT-proBNP test in this field requires further study.

show abstract

“…Pulmonary oedema may occur as a complication of pre-eclampsia without cardiac impairment (35). N-terminal pro-B type natriuretic peptide levels predict cardiovascular events during pregnancy, but these are also elevated in women with preeclampsia without any cardiac abnormality (36,37). A low NT-proBNP has a strong negative predictive value, but its high levels do not have a strong positive value (38).…”

Section: Management Of Heart Failurementioning

confidence: 99%

Peripartum management of hypertension: a position paper of the ESC Council on Hypertension and the European Society of Hypertension

Cífková

Johnson

Kahan

et al. 2019

European Heart Journal - Cardiovascular Pharmacotherapy

View full text Add to dashboard Cite

Hypertensive disorders are the most common medical complications in the peripartum period associated with a substantial increase in morbidity and mortality. Hypertension in the peripartum period may be due to the continuation of pre-existing or gestational hypertension, de novo development of pre-eclampsia or it may be also induced by some drugs used for analgesia or suppression of postpartum haemorrhage. Women with severe hypertension and hypertensive emergencies are at high risk of life-threatening complications, therefore, despite the lack of evidence-based data, based on expert opinion, antihypertensive treatment is recommended. Labetalol intravenously and methyldopa orally are then the two most frequently used drugs. Short-acting oral nifedipine is suggested to be used only if other drugs or iv access are not available. Induction of labour is associated with improved maternal outcome and should be advised for women with gestational hypertension or mild pre-eclampsia at 37 weeks’ gestation. This position paper provides the first interdisciplinary approach to the management of hypertension in the peripartum period based on the best available evidence and expert consensus.

show abstract

Association of serum N-terminal pro-brain natriuretic peptide levels with the severity of preeclampsia

Abstract: The ACOG has recently revised the grading of hypertensive diseases of pregnancy and the criteria for severe preeclampsia. In line with these revised guidelines, serum NT-proBNP levels appear to be a useful marker to evaluate the severity of preeclampsia.

Cited by 16 publications

References 22 publications

Preeclampsia: Postpartum Resolution of Hypertension, Proteinuria and Serum N-terminal B-type Natriuretic Peptide

Preeclampsia: Postpartum Resolution of Hypertension, Proteinuria and Serum N-terminal B-type Natriuretic Peptide

Cardiac Complications in Pregnancy: A Systematic Review and Meta-Analysis of Diagnostic Accuracy of BNP and N-Terminal Pro-BNP

Peripartum management of hypertension: a position paper of the ESC Council on Hypertension and the European Society of Hypertension

Contact Info

Product

Resources

About