Key result
Pregnancies with fetal cardiac malformations had significantly higher ANF levels in amniotic fluid (101.8 vs 34.2 pg/ml) and maternal blood (53.1 vs 42.1 pg/ml) compared to controls (p<0.01).
Why the study?
Are atrial natriuretic factor (ANF) levels in amniotic fluid and maternal venous blood altered in pregnancies with fetal cardiac malformations?
Observational (n=151)
Are atrial natriuretic factor (ANF) levels in amniotic fluid and maternal venous blood altered in pregnancies with fetal cardiac malformations?
Absolute Event Rate: 101.8% vs 34.2%
p-value: p=< 0.01
ANF levels in amniotic fluid and maternal venous blood are significantly elevated early in pregnancy when fetuses have cardiac malformations, potentially reflecting fetal pathophysiological mechanisms.
May support ANF as an early marker of fetal cardiac malformations; hypothesis-generating and requires prospective validation before any clinical role.
OBJECTIVE: We evaluated the levels of atrial natriuretic factor (ANF) in amniotic fluid and in maternal venous blood in pregnancies with fetal cardiac malformations and chromosomal abnormalities. METHOD: Between the 16th and 18th week of pregnancy, 151 women were divided into three groups. Group A included patients at lowest risk, carrying a fetus with a normally developing heart and normal karyotype (control group). Group B included women with a fetus suffering from cardiac malformations, with or without associated chromosomal abnormalities. Group C included women carrying a fetus affected with chromosomal abnormalities without congenital cardiopathies. ANF was evaluated by radioimmunoassay. RESULTS: In maternal venous blood, the mean levels of ANF were 42.1, 53.1 and 38.7 pg/ml in groups A, B and C, respectively. In amniotic fluid, the mean levels of ANF were 34.2, 101.8 and 35.8 pg/ml in groups A, B and C, respectively. In group A (control group) there was no statistical difference in ANF levels across the gestational age range of 16-18 weeks, either in amniotic fluid or in maternal venous blood. A significant difference of ANF content in maternal venous blood was revealed in comparing group A with group B (p < 0.01), and group C with group B (p < 0.01). A statistically significant difference in ANF levels was also found in amniotic fluid between group A and group B (p < 0.01), and between group C and group B (p < 0.01). No statistically significant differences were found between group C and group A in comparing ANF levels in maternal venous blood and amniotic fluid. CONCLUSION: ANF levels in amniotic fluid and in maternal venous blood are increased early in the case of fetuses with cardiac malformations, with or without associated karyotype alteration. Chromosomally abnormal fetuses without heart malformations have normal ANF levels. These results could be useful for elucidating fetal pathophysiology mechanisms.
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Lieto et al. (2002) conducted an observational in Fetal cardiac malformations and chromosomal abnormalities (n=151). Fetal cardiac malformations vs. Normally developing heart and normal karyotype was evaluated on Atrial natriuretic factor (ANF) levels in amniotic fluid (pg/ml) (p=< 0.01). Pregnancies with fetal cardiac malformations had significantly higher ANF levels in amniotic fluid (101.8 vs 34.2 pg/ml) and maternal blood (53.1 vs 42.1 pg/ml) compared to controls (p<0.01).
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