Amino-terminal pro-brain natriuretic peptide in normal and hypertensive pregnancy

Objectives: To investigate serum levels of amino-terminal pro-brain natriur etic peptide (Nt pro-BNP) as an index of left-ventricular function in norma l pregnancy and pregnancies complicated by hypertension and also to investi gate levels in both primigravid and multigravid women. Methods: Women with hypertension in pregnancy (at least two readings of sys tolic blood pressure > 140 mm Hg and diastolic blood pressure > 90 mm Hg) ( n=24) and normotensive women (n=42) were included in the study. Serum Nt pr o-BNP was measured using an enzyme-linked immunosorbent assay technique. Results: The median serum Nt pro-BNP level in pregnancies complicated by hy pertension was 420 fmol/L, which was significantly greater than that measur ed in samples obtained from normotensive women in pregnancy (340 fmol/L) (p =0.03). There was a nonsignificant trend toward increased levels in protein uric as compared to nonproteinuric hypertension in pregnancy. Multigravida had higher Nt pro-BNP levels (n=26; median Nt pro-BNP=358 fmol/L) than prim igravida (n=16; median Nt pro-BNP=278 fmol/L) (p=0.01) in association with normal pregnancy. Multigravida also demonstrated a dramatic rise in serum N t pro-BNP levels in association with hypertension in pregnancy (n=13; media n Nt pro-BNP=572 fmol/L) as compared to normal pregnancy (n=26; median Nt p ro-BNP=358 fmol/L) (p=0.009). Conclusion: Serum Nt pro-BNP is elevated in women with hypertensive disorde rs of pregnancy, indicating elevated left-ventricular filling pressures. Me asured serum levels in both normal and hypertensive pregnancy are higher in multigravida than in primigravida.