Association of maternal serum levels of n-terminal pro-brain natriuretic peptide with increasing severity of pre-eclampsia

Background: Hypertensive disorders in pregnancy account for 14% of global maternal mortality and are globally the second most common cause of maternal morbidity. Among the hypertensive disorders of pregnancy, pre-eclampsia and eclampsia lead to the most deaths. Pre-eclampsia can deteriorate quickly and affect multiple organ systems. Various biomarkers are increased in pre-eclamptic women, including N-terminal prohormone of brain natriuretic peptide (NT-proBNP). Hence, we studied the association of maternal serum levels of NT-proBNP with pre-eclampsia. Aims and Objectives: To determine serum levels of NT-proBNP in patients with pre-eclampsia and to see the association of increased levels of NT-proBNP with the severity of pre-eclampsia. Materials and Methods: A prospective observational study was conducted on 88 hypertensive pregnant women presenting to the gynecology outpatient department of PBM hospital, Bikaner. They were divided into two groups: group A consisting of 44 pregnant women with pre-eclampsia without severe features, and group B consisting of 44 pregnant women with pre-eclampsia with severe features. After getting proper written consent, 5 mL of fasting venous sample was collected at term or just before induction of labor or in early labor in both groups. Results: Significantly elevated serum levels of NT-proBNP were seen in group B (pre-eclampsia with severe features) (mean systolic blood pressure [SBP]: 167.44±9.33, diastolic blood pressure [DBP]: 105.53±7.63) than in group A (pre-eclampsia without severe features) (mean SBP: 148.47±4.85, DBP: 98.36±4.88). The value of NT-proBNP was 489.2±259.2 in group B and 169.52±51.98 in group A (P<0.001). Thus, there is a significant association of NT-proBNP with increasing severity of pre-eclampsia. Conclusion: NT-proBNP is a useful marker to predict the severity of pre-eclampsia. Higher levels of NT-proBNP are seen in more severe grades of pre-eclampsia.