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Am J Perinatol 2025; 42(09): 1141-1151
DOI: 10.1055/a-2463-4410
Original Article

Effect of Maternal Body Mass Index on N-Terminal Pro B-Type Natriuretic Peptide Levels in the Third Trimester

Upma Saxena
1   Department of Obstetrics and Gynecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
,
Priyanka Yadav
1   Department of Obstetrics and Gynecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
,
Abhishek Lachyan
1   Department of Obstetrics and Gynecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
,
Anita Rani
2   Department of Biochemistry, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
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Funding None.
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Abstract

Objective

Maternal body mass index (BMI) and cardiac biomarkers, such as N-terminal pro-B-type natriuretic peptide (NT-proBNP), have been subjects of interest in obstetric research due to their potential implications for maternal and fetal health. Previous studies have explored the relationship between maternal BMI and various pregnancy outcomes, but the impact on NT-proBNP levels remains unclear. This study aims to investigate whether maternal BMI influences NT-proBNP levels in the third trimester of pregnancy, which could provide insights into maternal cardiovascular health during late gestation.

Study Design

A total of 234 singleton pregnant women in their third trimester (28–40 weeks) were recruited from Antenatal Care Clinic. Exclusion criteria included preexisting cardiac or renal conditions, hypertension, diabetes mellitus, and other specific medical conditions. Participants were categorized into BMI groups (< 23, 23–24.9, 25–29.9, and ≥30 kg/m2), and their NT-proBNP levels were measured using quantitative enzyme-linked immunosorbent assay kits. Statistical analyses including Spearman correlation, chi-squared test, Kruskal–Wallis test, and regression analysis were performed to assess the association between maternal BMI and NT-proBNP levels.

Results

The study population exhibited a range of BMI and NT-proBNP levels within normal ranges. No significant correlation was found between maternal age, parity, and NT-proBNP levels. Similarly, no significant association was observed between maternal BMI and NT-proBNP levels across different BMI categories. Trend analyses showed no consistent relationship between BMI and NT-proBNP levels. Multivariate and univariate regression analyses confirmed the lack of significant association between maternal BMI and NT-proBNP levels.

Conclusion

Contrary to expectations, this study found no significant effect of maternal BMI on NT-proBNP levels in the third trimester of pregnancy. These findings suggest that factors other than maternal BMI may predominantly influence NT-proBNP levels during late gestation. Further research is warranted to elucidate the complex interactions between maternal physiology, BMI, and cardiovascular biomarkers during pregnancy.

Key Points

  • This study aimed to examine the influence of maternal BMI on NT-proBNP.

  • No significant correlation between maternal BMI and NT-proBNP levels was found.

  • Other factors likely influence NT-proBNP levels, warranting further research.

Keywords

maternal BMI - NT-proBNP - observational study - pregnancy - third trimester

Note

Obtaining ethical clearance from the Institutional Ethical Committee (IEC/VMMC/SJH/Thesis/06/2022/CC-161).


Authors' Contributions

Conceptualization: P.Y., U.S.; data curation: P.Y., U.S.; formal Analysis: P.Y., U.S.; funding acquisition: N/A; investigation: P.Y., U.S.; methodology: P.Y., U.S.; project administration: U.S.; resources: P.Y., U.S., A.L.; software: SPSS; supervision: U.S., A.L., A.R.; validation: U.S., A.L., A.R.




Publication History

Received: 07 October 2024

Accepted: 04 November 2024

Article published online:
04 December 2024

© 2024. Thieme. All rights reserved.

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  • References

  • 1 Sharma G, Ying W, Silversides CK. The importance of cardiovascular risk assessment and pregnancy heart team in the management of cardiovascular disease in pregnancy. Cardiol Clin 2021; 39 (01) 7-19
    CrossrefPubMedSearch in Google Scholar
  • 2 National Institute for Health and Care Excellence. NG106. Chronic Heart Failure in Adults: Diagnosis and Management. NICE; 2018
    Search in Google Scholar
  • 3 Athavale B, Pathak J. Study of the role of plasma NT-proBNP in the diagnosis of heart failure. J Assoc Physicians India 2022; 70 (07) 11-12
    PubMedSearch in Google Scholar
  • 4 Belagavi AC, Rao M, Pillai AY, Srihari US. Correlation between NT proBNP and left ventricular ejection fraction in elderly patients presenting to emergency department with dyspnoea. Indian Heart J 2012; 64 (03) 302-304
    CrossrefPubMedSearch in Google Scholar
  • 5 Dockree S, Brook J, Shine B, James T, Vatish M. Pregnancy-specific reference intervals for BNP and NT-pro BNP-changes in natriuretic peptides related to Pregnancy. J Endocr Soc 2021; 5 (07) bvab091
    CrossrefPubMedSearch in Google Scholar
  • 6 Muscari A, Bianchi G, Forti P, Magalotti D, Pandolfi P, Zoli M. Pianoro Study Group. N-terminal pro B-type natriuretic peptide (NT-proBNP): a possible surrogate of biological age in the elderly people. Geroscience 2021; 43 (02) 845-857
    CrossrefPubMedSearch in Google Scholar
  • 7 Welsh P, Campbell RT, Mooney L. et al. Reference ranges for NT-proBNP and risk factors for higher NT-proBNP concentrations in a large general population cohort. Circ Heart Fail 2022; 15 (10) e009427
    CrossrefPubMedSearch in Google Scholar
  • 8 Ker JA, Soma-Pillay P. NT-proBNP: when is it useful in obstetric medicine?. Obstet Med 2018; 11 (01) 3-5
    CrossrefPubMedSearch in Google Scholar
  • 9 Moungmaithong S, Sahota DS, Leung B. et al. Evaluation of N-terminal pro-B-type natriuretic peptide and glycosylated fibronectin for the first trimester prediction of pre-eclampsia. Ultrasound Obstet Gynecol ISUOG 2022; 60 (s1): 86-86
    PubMedSearch in Google Scholar
  • 10 Kim HL, Kim MA, Oh S. et al; Korean Heart Failure Registry. The impact of body mass index on the prognostic value of N-terminal proB-type natriuretic peptide in patients with heart failure: an analysis from the Korean Heart Failure (KorHF) Registry. Int J Heart Fail 2019; 2 (01) 45-54
    CrossrefPubMedSearch in Google Scholar
  • 11 Denoble AE, Moyett JM, Goldstein SA. et al. Prospective observational study of N-terminal pro-brain natriuretic peptide levels in obese and nonobese women during pregnancy. Am J Perinatol 2023; 40 (05) 467-474
    Thieme ConnectPubMedSearch in Google Scholar
  • 12 Ha Manh T, Do Anh D, Le Viet T. Effect of body mass index on N-terminal pro-brain natriuretic peptide values in patients with heart failure. Egypt Heart J 2023; 75 (01) 75
    CrossrefPubMedSearch in Google Scholar
  • 13 Parcha V, Patel N, Kalra R. et al. Obesity and serial NT-proBNP levels in guided medical therapy for heart failure with reduced ejection fraction: insights from the GUIDE-IT trial. J Am Heart Assoc 2021; 10 (07) e018689
    CrossrefPubMedSearch in Google Scholar
  • 14 Welsh P, Campbell RT, Mooney L. et al. Reference ranges for NT-proBNP and risk factors for higher NT-proBNP concentrations in a large general population cohort. Circ Heart Fail 2022; 15 (10) e009427
    CrossrefPubMedSearch in Google Scholar
  • 15 Wang TJ, Larson MG, Levy D. et al. Impact of obesity on plasma natriuretic peptide levels. Circulation 2004; 109 (05) 594-600
    CrossrefPubMedSearch in Google Scholar
  • 16 Minhas AS, Rooney MR, Fang M, Zhang S, Ndumele CE, Tang O. et al. Prevalence and correlates of elevated n-terminal pro-b-type natriuretic peptide in pregnant women in the general US population. JACC Adv 2023; Mar; 02 (02) 100265
    CrossrefPubMedSearch in Google Scholar
  • 17 Costello-Boerrigter LC, Boerrigter G, Redfield MM. et al. Amino-terminal pro-B-type natriuretic peptide and B-type natriuretic peptide in the general community: determinants and detection of left ventricular dysfunction. J Am Coll Cardiol 2006; 47 (02) 345-353
    CrossrefPubMedSearch in Google Scholar