脑钠尿肽在评估子痫前期孕妇胎儿状况及预测围产结局中的作用

Background: Assessing fetal status and predicting perinatal outcomes in pregnant women with pre-eclampsia is a pressing issue in contemporary obstetrics. The management of pregnant women with pre-eclampsia and fetal growth retardation primarily relies on instrumental diagnostic methods; however, an additional biomarker capable of predicting the progression of this pregnancy complication and fetal deterioration is highly relevant.

Aim: To determine the prognostic value of brain natriuretic peptide (NT-proBNP) for perinatal outcomes in patients with pre-eclampsia.

Methods: A prospective study was conducted involving 110 pregnant women at 22–40 weeks of gestation to improve perinatal outcomes and reduce neonatal morbidity and mortality. The main group included 80 patients with confirmed pre-eclampsia of varying severity. Two subgroups were identified: 40 (50%) patients with fetal growth retardation and impaired umbilical artery blood flow, and 40 (50%) patients with pre-eclampsia without fetal growth retardation. The control group consisted of 30 women with uncomplicated pregnancies. The study was conducted from November 2022 to July 2024. Serum NT-proBNP levels were measured using electrochemiluminescence immunoassay. Uteroplacental and fetal blood flow was assessed upon the patient’s admission to the hospital using a Siemens ultrasound machine.

Results: All patients completed the study. A statistically significant association was found between elevated NT-proBNP levels and fetal growth retardation with impaired umbilical artery blood flow (p < 0.001). In the subgroup with fetal growth retardation and impaired umbilical artery blood flow, the NT-proBNP level was significantly higher compared with the subgroup without fetal growth retardation (227.25 vs. 79.50 pg/mL, respectively).

Conclusion: Patients with pre-eclampsia of any severity who develop fetal growth retardation and impaired fetal circulation have NT-proBNP levels 2.8 times higher than those with pre-eclampsia without growth retardation. This supports the role of maternal cardiac maladaptation in pre-eclampsia. A threshold NT-proBNP value predictive of fetal growth retardation and impaired umbilical artery flow has been identified.