Franz Maximilian B, Andreas Martin, Schiessl Barbara, Zeisler Harald, Neubauer Anna, Kastl Stefan P, Hess Georg, Rhomberg Franziska, Zdunek Dietmar, Maurer Gerald, Schlembach Dietmar, Heinze Georg, Szekeres Thomas, Gottsauner-Wolf Michael
1st Department of Obstetrics and Gynecology, University of Munich, Munich, Germany.
Acta Obstet Gynecol Scand. 2009;88(2):234-7. doi: 10.1080/00016340802596025.
Serum concentrations of the amino-terminal pro-B-type natriuretic peptide (NT-proBNP) may be used to monitor cardiac function during pregnancy but normal values are not established for this purpose. Therefore, we investigated NT-proBNP in normotensive healthy pregnancies compared to a non-pregnant control group. Serum NT-proBNP was measured in 94 normotensive, healthy pregnant women (32+/-6 years) every five weeks beginning from 12th gestational week (GW) in a longitudinal study and compared to a non-pregnant control group of 521 women (32+/-7 years). Pooled median serum NT-proBNP levels (25th; 75th percentile) were significantly higher in pregnant women compared to non-pregnant women (56 (33; 95) pg/ml vs. 38 (22; 62) pg/ml (p<0.001)). NT-proBNP increased during pregnancy to 73 (51; 124) pg/ml in the 11+6 to 15+6 GW (p<0.001). However, NT-proBNP levels from 23+0 GW towards term were comparable to non-pregnant controls. NT-proBNP is significantly elevated in healthy pregnancies until mid-pregnancy. As preeclampsia and gestational hypertension are associated with increased NT-proBNP, our results have to be considered in future diagnostic approaches using NT-proBNP for these pathologic conditions.
血清氨基末端B型利钠肽原(NT-proBNP)浓度可用于监测孕期心脏功能,但尚未为此确定正常参考值。因此,我们将血压正常的健康孕妇与非孕对照组进行比较,对NT-proBNP进行了研究。在一项纵向研究中,从妊娠第12周(GW)开始,每5周对94名血压正常的健康孕妇(32±6岁)测定血清NT-proBNP,并与521名非孕女性(32±7岁)的对照组进行比较。孕妇的血清NT-proBNP合并中位数水平(第25百分位数;第75百分位数)显著高于非孕妇(56(33;95)pg/ml对38(22;62)pg/ml,p<0.001)。在妊娠11+6至15+6 GW期间,NT-proBNP升高至73(51;124)pg/ml(p<0.001)。然而,从23+0 GW到足月,NT-proBNP水平与非孕对照组相当。在健康妊娠中,直到妊娠中期NT-proBNP均显著升高。由于子痫前期和妊娠高血压与NT-proBNP升高有关,在未来使用NT-proBNP诊断这些病理状况时,必须考虑我们的研究结果。