Pregnancy and the immediate 48-hour postpartum period in normal women were associated with significant increases in BNP/NT-proBNP (P<0.0001) and left ventricular volume (P=0.021).
Observational (n=116)
In normal pregnancies, BNP, NT-proBNP, and left atrial/ventricular volumes transiently increase within 48 hours postpartum without evidence of altered diastolic function.
p-value: p=<0.0001
OBJECTIVE: To evaluate B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) and cardiac structure and function in normal women through pregnancy and the postpartum. METHODS: In this prospective observational study, we obtained serial transthoracic echocardiograms, BNP, and NT-proBNP at seven intervals from 6 weeks' gestation through 12 months postpartum. Women with hypertension or cardiac disease were excluded. Using 6-12 months postpartum as reference for non-pregnant levels, echocardiogram measurements and BNP/NT-proBNP were compared over time using linear mixed models with Tukey-Kramer adjustment for multiple comparisons. RESULTS: Of 116 patients, data was available for 78-114 healthy pregnant or postpartum women within each time interval, and 102 patients provided data for ≥4 intervals. Compared to 6-12 months postpartum, BNP and NT-proBNP remained stable through pregnancy and delivery, increased within 48 h postpartum (P<0.0001), then returned to baseline. Left ventricular volume increased within 48 h postpartum (P=0.021) while left atrial volume increased at 18-24 weeks (P=0.0002), 30-36 weeks (P<0.0001) and within 48 h postpartum (P=0.002). The transmitral early/late diastolic velocity (E/A) ratio, transmitral early/peak mitral annulus diastolic velocity (E/E') ratio, isovolumic relaxation times, and mitral valve deceleration times were similar within 48 h and 6-12 months postpartum. CONCLUSION: In normal women, BNP/NT-proBNP, left atrial, and left ventricular volumes increase within 48 h postpartum without indications of altered diastolic function.
Burlingame et al. (Sun,) conducted a observational in Normal pregnancy (n=116). Pregnancy and postpartum period vs. 6-12 months postpartum (non-pregnant reference) was evaluated on B-type natriuretic peptide (BNP), N-terminal pro-B-type natriuretic peptide (NT-proBNP), and cardiac structure and function (p=<0.0001). Pregnancy and the immediate 48-hour postpartum period in normal women were associated with significant increases in BNP/NT-proBNP (P<0.0001) and left ventricular volume (P=0.021).
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