NT-proBNP in women with gestational hypertension, uncomplicated preeclampsia, normotensive pregnancies, and echocardiographic correlations

Dolina Gencheva, Fedya Nikolov, Ekaterina Uchikova, Blagovesta Pencheva, Rosen Mihaylov

Abstract

Objective: To determine and compare serum NT-proBNP levels among women with gestational hypertension (GH), uncomplicated preeclampsia (PE), and normotensive pregnancies, and to assess their associations with maternal clinical characteristics and echocardiographic parameters.
Methods: This prospective, single-centre study analysed 35 women with GH, 36 with uncomplicated PE, and 50 healthy pregnant controls. All participants underwent clinical evaluation, comprehensive two-dimensional echocardiography, and biomarker testing.
Results: NT-proBNP concentrations were significantly lower in the GH group (42.3 ± 52.0 pg/mL) compared to both normotensive pregnancies (50.1 ± 40.3 pg/mL; p = 0.04) and uncomplicated PE cases (87.7 ± 75.3 pg/mL; p = 0.002). No significant difference was observed between uncomplicated PE and controls. ROC curve analysis demonstrated a moderate discriminatory ability of NT-proBNP for GH versus PE (AUC = 0.71); women with levels ≤ 6.25 pg/mL were 7.9 times more likely to have GH than PE. In normotensive pregnancy, NT-proBNP correlated with parameters of cardiac chamber dilation. In PE, higher NT-proBNP levels were associated with more favourable left ventricular functional indices, whereas fewer correlations were observed in the GH cohort.
Conclusion: NT-proBNP levels differ significantly among hypertensive disorders of pregnancy and may reflect distinct pathophysiological mechanisms and cardiovascular adaptation patterns.