INFLUENCE OF CARDIAC PEPTIDE NT-PROBNP LEVELS ON MATERNAL BLOOD PARAMETERS AND FETAL CONDITION IN EARLY PREECLAMATION OF PREGNANT WOMEN

Relevance of the topic. N-terminal brain natriuretic peptide NT- proBNP is a cardiac peptide that is mainly synthesized and secreted by the left ventricular myocardium. It is considered one of the key biochemical indicators of heart diseases. It is known that its level in the blood is significantly increased in patients with heart failure and in case of rejection of a transplanted heart. However, no studies have been conducted so far on changes in NT-proBNP concentration in pathological conditions associated with pregnancy, in particular in preeclampsia. The effect of this peptide on the condition of the mother and fetus in normal and pathological conditions remains incompletely understood. The aim of the research. To study the relationship between serum concentrations of N-terminal brain natriuretic peptide (NT-proBNP) and blood parameters of the mother and fetus. The material and methods. The total number of women included in the study was 90 people. All pregnant women were examined at 32-36 weeks of gestation. The study group included 60 patients, whose pregnancy was complicated by early moderate preeclampsia. The control group consisted of 30 women at the same gestational age, in which the pregnancy proceeded without complications. The inclusion of patients in the study groups took place after signing an informed consent. The recruitment of patients was carried out on the basis of the Chernivtsi Regional Perinatal Center and the Medical Center for Infertility Treatment (Chernivtsi, Ukraine). Laboratory studies were carried out in the Educational and Scientific Laboratory of the Bukovina State Medical University, which is certified accordingly. The determination of the NT-proBNP level was carried out using the MAGLUMI BNP test system (manufacturer: Shenzhen New Industries Biomedical Engineering, Shenzhen, China). Venous blood sampling from pregnant women was performed once on an empty stomach at 8:00 in the morning. For analysis, 500 μl of plasma was placed in disposable tubes and loaded into the MAGLUMI 1000 automatic chemiluminescent immunoanalyzer. The research was approved by the Commission on Biomedical Ethics of the Bukovina State Medical University regarding compliance with the rules for conducting medical scientific research (protocol No. 9 dated 06/20/2024). Results of the research. It was found that the average level of NT-proBNP in the group of women with preeclampsia was significantly higher compared to the control (79.5±37.4 pg/ml, in the control group 32.0±12.0 pg/ml, p<0.001). The hemoglobin level in the group with preeclampsia was 111.7±11.0 g/l, in the control group – 119.4±8.2 g/l (p=0.004). The hematocrit in the experimental group was 32.7±4.2 %, in the control group 35.8±2.3 % (p=0.004). No significant difference in the assessment of the fetal biophysical profile (BPP) between the groups was found. The following correlations were established between the studied indicators: the assessment of the fetal biophysical profile in points in patients included in the main group was negatively correlated with the value of NT-proBNP in blood plasma (r = -0.41, p = 0.0092) and the level of NT-proBNP in the group of women with preeclampsia was negatively correlated with the fetal body weight at birth (r = -0.71, p = 0.006). Conclusions. The level of cardiac peptide NT-proBNP significantly increases in the blood of women whose pregnancy was complicated by preeclampsia and is negatively correlated with the assessment of the fetal biophysical profile and with body weight at birth. In our opinion, this indicates a negative impact of hypertension caused by preeclampsia, as well as changes in the maternal myocardium, accompanied by an increase in the level of NT-proBNP, on the condition of the intrauterine fetus. A decrease in hemoglobin and hematocrit levels without the development of clinically significant anemia in pregnant women with preeclampsia, accompanied by an increase in the concentration of NT-proBNP in the blood plasma, in our opinion, may indicate a more pronounced hemodilution in such patients, resulting in hypertension, which is one of the signs of preeclampsia.