EP17.27: Prognostic value of maternal N‐terminal pro‐B‐type natriuretic peptide for prediction of adverse maternal outcomes in women with pre‐eclampsia

N-terminal pro-B-type natriuretic peptide (NT-proBNP), a marker for cardiac volume overload and cardiac insufficiency, has been found to be increased in pregnancies affected by pre-eclampsia. This study aimed to evaluate the prognostic value of maternal serum NT-proBNP for the prediction of adverse maternal outcomes in women with established diagnosis of pre-eclampsia. This was a retrospective cohort study including singleton pregnancies with a diagnosis of pre-eclampsia who underwent assessment of serum NT-proBNP at the Medical University of Vienna between 2018 and 2023. The primary outcome was the association of NT-proBNP with adverse maternal composite outcome. Composite adverse maternal outcome was defined as ICU admission, death, lung edema, liver dysfunction, renal insufficiency, hemorrhage, placental abruption, neurological complications and HELLP syndrome. 137 singleton pregnancies diagnosed with pre-eclampsia who underwent sampling of NT-proBNP were included. Maternal adverse outcomes were observed in 63 (46%) patients. There were no significant differences in baseline characteristics between cases with or without adverse maternal events (p > 0.005 for all). Median gestational age (GA) at sampling was 33.86 (IQR 26-37, [95% CI 32-35]) and 33.14 weeks (IQR 33.14, [95% CI 31-35]), respectively (p = 0.9483). Median GA at delivery was 35.86 (IQR 30-38, [95% CI 34-37]) and 36.14 (IQR 33-38, [95% CI 35-37]) weeks. Overall median NT-proBNP was 69.9 pg/mL (IQR 33-166, [95% CI 54-90]). NT-proBNP was significantly higher in the group with maternal adverse outcome (median 115 pg/mL, IQR 44-348, [95% CI 70-174]) compared to women without adverse outcomes (median 55.65 pg/mL, IQR 29-119, [95% CI 46-70], p = 0.0018). In pre-eclamptic patients, higher serum NT-proBNP values were associated with maternal adverse outcome. The cardiovascular parameter could be a useful tool for surveillance as well as prediction of adverse maternal outcomes in pregnancies complicated by pre-eclampsia.