NT-proBNP as a Biomarker for Disease Severity and Maternal Complications in Preeclampsia

Background:Preeclampsia is a major contributor to maternal and perinatal morbidity and mortality worldwide.Beyond reflecting placental dysfunction, preeclampsia also indicates maternal cardiovascular maladaptation.N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a biomarker of myocardial wall stress and may be associated with concurrent disease severity and maternal complications in preeclampsia. Material/Methods:A cross-sectional study was conducted involving 74 pregnant women at 20 or more weeks of gestation with a diagnosis of preeclampsia (n = 35) or severe preeclampsia (n = 39) at 3 tertiary referral hospitals in Indonesia.Plasma NT-proBNP levels were measured using enzyme-linked immunosorbent assay.Associations of NT-proBNP levels with blood pressure and maternal complications were analyzed.Diagnostic performance was evaluated using receiver operating characteristic (ROC) analysis. Results:Median NT-proBNP concentrations were higher in participants with severe features than in those without severe features (3250 [IQR 2870-3650] vs 1390 [IQR 240-1850] pg/mL; P < 0.001).NT-proBNP correlated positively with systolic (r = 0.647) and diastolic blood pressure (r = 0.607).ROC analysis identified an internally derived exploratory threshold of 2770 pg/mL (AUC 0.936; 95% CI 0.853-0.979),with sensitivity of 76.9% and specificity of 97.1%.Elevated NT-proBNP levels were significantly associated with eclampsia, renal dysfunction, and uteroplacental disorders (P < 0.05).This cohort-derived threshold requires prospective external validation before clinical implementation. Conclusions:NT-proBNP levels were significantly elevated in severe preeclampsia and associated with major maternal complications, supporting its role as an adjunct biomarker for disease severity assessment.