Abstract
Objectives: B-natriuretic peptide (BNP) is widely used as a prognostic marker in non-pregnant patients, however there is no consensus on its utility in informing prognosis in pregnant women with heart disease. This systematic review aims to combine current studies which measure BNP levels to predict adverse outcome in pregnant women with heart disease.
Design: This study forms a systematic review. Meta-analysis was not possible as outcomes were reported heterogeneously.
Methods: Retrospective and prospective cohort studies were included. Those with less than 10 participants were excluded. We required that studies measured BNP or NT-pro-BNP levels during pregnancy in women with heart disease and compared BNP levels to maternal and/or fetal complications. Medline and Embase were searched from inception to December 2019. Risk of bias was assessed using the Newcastle-Ottawa scale.
Results: Seven studies were included, involving 787 women. In women who had an adverse cardiac event during pregnancy or in the postnatal period the median BNP ranged between 185-354pg/mL and for women who had no adverse event, median BNP ranged between 73-100pg/mL. One study observed the mean BNP in women who had a small for gestational age neonate as 160 +-183pg/mL, compared to women with neonates with normal growth as 77.1 +- 66.5pg/mL, p=0.003.
Conclusion: The available evidence suggests that women with a higher BNP are more likely to have an adverse cardiac event or a small for gestational age neonate. Further studies with robust methodology are needed to clarify the prognostic value of BNP in pregnant women with heart disease.
Design: This study forms a systematic review. Meta-analysis was not possible as outcomes were reported heterogeneously.
Methods: Retrospective and prospective cohort studies were included. Those with less than 10 participants were excluded. We required that studies measured BNP or NT-pro-BNP levels during pregnancy in women with heart disease and compared BNP levels to maternal and/or fetal complications. Medline and Embase were searched from inception to December 2019. Risk of bias was assessed using the Newcastle-Ottawa scale.
Results: Seven studies were included, involving 787 women. In women who had an adverse cardiac event during pregnancy or in the postnatal period the median BNP ranged between 185-354pg/mL and for women who had no adverse event, median BNP ranged between 73-100pg/mL. One study observed the mean BNP in women who had a small for gestational age neonate as 160 +-183pg/mL, compared to women with neonates with normal growth as 77.1 +- 66.5pg/mL, p=0.003.
Conclusion: The available evidence suggests that women with a higher BNP are more likely to have an adverse cardiac event or a small for gestational age neonate. Further studies with robust methodology are needed to clarify the prognostic value of BNP in pregnant women with heart disease.
| Original language | English |
|---|---|
| Article number | 100039 |
| Journal | International Journal of Cardiology Congenital Heart Disease |
| Volume | 2 |
| DOIs | |
| Publication status | Published - Feb 2021 |
| Event | 12th Advanced Symposium on Congenital Heart Disease in the Adult - Royal College of Physicians, London, United Kingdom Duration: 21 Sept 2020 → 22 Sept 2020 |