Rodriguez David, Garcia-Rivas Gerardo, Laresgoiti-Servitje Estibalitz, Yañez Jesus, Torre-Amione Guillermo, Jerjes-Sanchez Carlos
Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud.
BMJ Open. 2018 Oct 17;8(10):e022562. doi: 10.1136/bmjopen-2018-022562.
To define and compare the reference interval of B-type natriuretic peptide (BNP) in healthy newborns (HN) from healthy mothers and with severe pre-eclampsia.
Prospective, multicentre, cross-sectional study.
Four obstetric wards of second-level academic hospitals.
167 HN, from 146 healthy and 21 severe pre-eclamptic women. We included newborns from healthy mothers with full-term pregnancies (38 to 42 gestational weeks), who received adequate prenatal care and who had Apgar scores ≥7 at 0 and 5 min. Newborns with chromosomopathies identified during prenatal consultations, those with respiratory distress and those with cardiac or pulmonary disease detected in the first paediatric evaluation were excluded from this study. In the group of pre-eclamptic women, we considered the same inclusion criteria, but the patients also had to meet the diagnostic criteria for pre-eclampsia with severity features, according to the American College of Obstetricians and Gynaecologists guidelines. The same exclusion criteria used for the healthy group were applied to the pre-eclampsia-associated newborn.
A single blood sample from the umbilical cord artery after delivery (vaginal or caesarean section).
Reference level of BNP in HN.
In the HN group, the median BNP was 12.15 pg/mL (IQR 7.7-16.8 pg/mL) and in the pre-eclamptic group 20.8 pg/mL (IQR 5.8-46.5 pg/mL). The reference interval for BNP in HN was 5pg/mL (95% CI 5 to 5) to 34 pg/mL (95% CI 28.4 to 38.8). We identified higher expression of BNP in newborns from pre-eclamptic women overall (p=0.037, r=0.16) and in newborns exposed to stress conditions, such as complications during labour and delivery (p=0.004, r=0.33).
In HN, BNP concentrations at birth were lower than reported in other similar populations. In neonates with stress conditions, the higher expression of this biomarker establishes another possible link between stress and the cardiovascular response.
NCT02574806; Pre-results.
定义并比较来自健康母亲和重度子痫前期母亲的健康新生儿（HN）中B型利钠肽（BNP）的参考区间。
前瞻性、多中心、横断面研究。
二级学术医院的四个产科病房。
167名HN，来自146名健康女性和21名重度子痫前期女性。我们纳入了足月妊娠（38至42孕周）、接受过充分产前护理且出生后0分钟和5分钟阿氏评分≥7分的健康母亲所生的新生儿。产前咨询时确诊患有染色体病、有呼吸窘迫以及首次儿科评估时发现患有心脏或肺部疾病的新生儿被排除在本研究之外。在子痫前期女性组中，我们采用相同的纳入标准，但患者还必须符合美国妇产科医师学会指南中重度子痫前期的诊断标准。健康组使用的相同排除标准也适用于子痫前期相关新生儿。
分娩后（经阴道或剖宫产）从脐动脉采集一份血样。
HN中BNP的参考水平。
在HN组中，BNP中位数为12.15 pg/mL（四分位间距7.7 - 16.8 pg/mL），子痫前期组为20.8 pg/mL（四分位间距5.8 - 46.5 pg/mL）。HN中BNP的参考区间为5 pg/mL（95%置信区间5至5）至34 pg/mL（95%置信区间28.4至38.8）。我们发现，总体而言，子痫前期女性所生新生儿中BNP表达更高（p = 0.037，r = 0.16），在经历应激状况（如分娩过程中的并发症）的新生儿中也是如此（p = 0.004，r = 0.33）。
在HN中，出生时的BNP浓度低于其他类似人群的报道。在有应激状况的新生儿中，这种生物标志物的高表达建立了应激与心血管反应之间的另一个可能联系。
NCT02574806；预结果。
