Pregnant women may have highest NT-proBNP in first trimester compared to third trimester

The authors reported the following findings:

• Among pregnant women in the first trimester, the prevalence of elevated NT-proBNP (>125 pg/mL) was 20.0% (SE, 6.6%) compared to 2.4% (SE, 0.8%) among women in the third trimester and 8.0% among nonpregnant women.
• After adjustment for demographics and cardiovascular risk factors, NT-proBNP was 44% higher (absolute difference 26.4 pg/mL) in the first trimester of pregnancy compared to nonpregnant women.
• Among pregnant women only, adjusted NT-proBNP was 46% lower (absolute difference −22.2 pg/mL) in women in the third trimester versus women in the first trimester.
• NT-proBNP was inversely associated with body mass index and with systolic blood pressure.

"We found higher NT-proBNP levels in women in the pregnancy's first trimester compared with nonpregnant women and women in their later trimester," the researchers wrote. "Similarly, there was a higher prevalence of increased NT-proBNP in the first trimester versus nonpregnant women and those in late trimesters."

Across the second and third trimesters, systolic blood pressure and BMI were associated with lower NT-proBNP. The results suggest that NT-proBNP levels are dynamic throughout pregnancy and differ from nonpregnant women.

"Our findings indicate that NT-proBNP interpretation in pregnant women without CVD is complex," the researchers conclude. "BMI, trimester, and blood pressure may need to be considered for NT-proBNP assessment in pregnant women."

Reference:

Minhas, A. S., Rooney, M. R., Fang, M., Zhang, S., Ndumele, C. E., Tang, O., Schulman, S. P., Michos, E. D., McEvoy, J. W., Echouffo-Tcheugui, J., Christenson, R., & Selvin, E. (2023). Prevalence and Correlates of Elevated NT-proBNP in Pregnant Women in the General U.S. Population. JACC: Advances, 2(2), 100265. https://doi.org/10.1016/j.jacadv.2023.100265