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Is ProBNP a New Marker for Predicting Intrauterine Growth Restriction?
Purpose To evaluate the usability of first-trimester maternal serum ProBNP levels in the prediction of intrauterine growth restriction (IUGR). Methods In this prospective study, blood samples taken from 500 women who applied to our polyclinic for routine serum aneuploidy screening between the 11–14th gestational weeks were centrifuged. The obtained plasma samples were placed in Eppendorf tubes and stored at −80+°C. For the final analysis, first-trimester maternal serum ProBNP levels of 32 women diagnosed with postpartum IUGR and 32 healthy women randomly selected as the control group were compared. FGR was defined as estimated fetal weight below the 10th percentile for the gestational age.
Results The mean ProBNP levels were statistically and significantly higher in the women with intrauterine growth restriction (113.73±94.69 vs. 58.33±47.70 pg/mL, p<0.01). At a cut-off level of 50.93, ProBNP accurately predicted occurrence of IUGR (AUC+= 0.794 (95% confidence interval 0.679–0.910), p+= 0.001) with sensitivity and specificity rates of 78.1 and 69.0%, respectively. Conclusion First-trimester serum ProBNP level was significantly higher in women who developed IUGR compared to healthy controls. First-trimester ProBNP level can be used as a potential marker to predict the development of IUGR in pregnant women.
Received: 28 November 2020
Accepted after revision: 16 January 2021
10 March 2021 (online)
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- 1 American College of Obstetricians and Gynecologists ACOG Practice Bulletin No. 134: Fetal growth restriction. Obstet Gynecol 2013; 121: 1122-1133
- 3 Figueras F, Caradeux J, Crispi F. et al. Diagnosis and surveillance of late-onset fetal growth restriction. Am J Obstet Gynecol 2018; 218: S790-802.e1
- 4 Baschat AA.. Neurodevelopment after fetal growth restriction. Fetal Diagn Ther 2014; 36: 136-42
- 5 Pels A, Beune IM, van Wassenaer-Leemhuis AG. et al. Early-onset fetal growth restriction: a systematic review on mortality and morbidity. Acta Obstet Gynecol Scand 2020; 99: 153-166
- 6 Bursztyn M, Ariel I. Maternal-fetal deprivation and the cardiometabolic syndrome. J Cardiometab Syndr 2006; 1: 141-145
- 7 Tolsa CB, Zimine S, Warfield SK. et al. Early alteration of structural and functional brain development in premature infants born with intrauterine growth restriction. Pediatr Res 2004; 56: 132-138
- 8 Troughton R, Michael Felker G, Januzzi JL. Natriuretic peptide-guided heart failure management. Eur Heart J 2014; 35: 16-24
- 9 Ponikowski P, Voors AV, Anker SD. et al. ESC Scientific Document Group. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J 2016 (37) 2129-2200
- 10 Maalouf R, Bailey S. A review on B-type natriuretic peptide monitoring: assays and biosensors. Heart Fail Rev 2016; 21: 567-578
- 11 De Lemos JA, McGuire DK, Drazner MH. B-type natriuretic peptide in cardiovascular disease. Lancet 2003; 362: 316-322
- 12 Sadlecki P, Grabiec M, Walentowicz-Sadlecka M. Prenatal clinical assessment of NT-proBNP as a diagnostic tool for preeclampsia, gestational hypertension and gestational diabetes mellitus. PLoS ONE 2016; 11: e0162957
- 13 Bae JY, Seong WJ. Umbilical arterial N-terminal pro-B-type natriuretic peptide levels in preeclampsia, fetal growth restriction, preterm birth and fetal distress. Clin Exp Obstet Gynecol 2016; 43: 393-396
- 14 ACOG Practice Bulletin No. 204: Fetal Growth Restriction. Obstet Gynecol 2019; 133: e97-e109
- 15 Eroglu H, Turgal M, Senat A. et al. Maternal and fetal thiol/disulphide homeostasis in fetal growth restriction. J Maternal Fetal Neonat Med 2019; Aug 5 1-8
- 16 Sotiriadis A, Figueras F, Eleftheriades M. et al. First-trimester and combined first- and second-trimester prediction of small-for-gestational age and late fetal growth restriction. Ultrasound Obstet Gynecol 2019; 53: 55-61
- 17 He B, Hu C, Zhou Y. First-trimester screening for fetal growth restriction using Doppler color flow analysis of the uterine artery and serum PAPP-A levels in unselected pregnancies. J Matern Fetal Neonatal Med 2020; Jan 12 1-5
- 18 Yu N, Cui H, Chen X. et al. First trimester maternal serum analytes and second trimester uterine artery Doppler in the prediction of preeclampsia and fetal growth restriction. Taiwan J Obstet Gynecol 2017; 56: 358-361
- 19 Tihtonen KM, Koobi T, Vuolteenaho O. et al. Natriuretic peptides and hemodynamics in preeclampsia. Am J Obstet Gynecol 2007; 196: 328.e1-e7
- 20 Szabó G, Molvarec A, Nagy B. et al. Increased B-type natriuretic peptide levels in early-onset versus late-onset preeclampsia. Clin Chem Lab Med 2014; 52: 281-288
- 21 Giannubilo SR, Pasculli A, Tidu E. et al. Relationship between maternal hemodynamics and plasma natriuretic peptide concentrations during pregnancy complicated by preeclampsia and fetal growth restriction. J Perinatol 2017; 37: 484-487
- 22 Carbillon L, Uzan M, Uzan S. Pregnancy, vascular tone, and maternal hemodynamics: a crucial adaptation. Obstet Gynecol Surv 2000; 55: 574-581