N-terminal pro-B-type natriuretic peptide levels in pregnant women with heart disease and complications: A cohort study

Background: Heart diseases affect 1–4% of pregnancies, leading to fetomaternal complications. Brain natriuretic peptide is a key biomarker for assessing cardiac adaptation to pregnancy-related hemodynamic changes. The longer half-life of its terminal fragment, N terminal pro brain natriuretic peptide (NT-ProBNP), increases its diagnostic utility. Objective: This study aimed to evaluate the association between NT-proBNP serum levels and fetomaternal complications in pregnant women with cardiovascular disease. Materials and Methods: A prospective longitudinal study was conducted at the Cardiology and Obstetrics Clinic of Imam Reza hospital, Mashhad, Iran, from July 2019-July 2020. 50 pregnant women in their third trimester with cardiovascular disease (New York Heart Association class 2 or higher) were included. Based on NT-proBNP levels, participants were categorized into normal (n = 37) and elevated (n = 13) groups using a 125 pg/ml cutoff. Fetomaternal complications were assessed and analyzed. Results: Elevated NT-proBNP levels were significantly associated with increased hypertension in the second (p = 0.05) and third (p < 0.0001) visits and low Apgar scores (p = 0.05). A significant difference in drug history (p = 0.013) was observed between the groups. However, no significant differences were found in other variables, including intensive care unit)/neonatal intensive care unit admission, mode of delivery, electrocardiography findings, or echocardiographic results (p > 0.05). Conclusion: Elevated NT-proBNP levels are strongly linked to hypertension during pregnancy and low neonatal Apgar scores, highlighting its potential as a predictive biomarker for fetomaternal risk assessment.