TOPLINE:
N-terminal pro-brain natriuretic peptide (NT-proBNP) levels of 200 pg/mL or more independently predicted maternal-foetal complications in pregnant women with hypertensive disorders. Combining NT-proBNP with the angiogenic marker soluble fms-like tyrosine kinase 1/placental growth factor (sFlt‑1/PlGF) ratio further improved the ability to predict which women are at higher risk.
METHODOLOGY:
- Researchers conducted a prospective, multicentre observational study at two hospitals in Romania to evaluate how NT-proBNP helps predict maternal-foetal complications in hypertensive disorders of pregnancy and improves risk stratification when combined with the angiogenic marker (the sFlt‑1/PlGF ratio).
- They enrolled 180 pregnant women after 20 weeks of gestation who had singleton pregnancies, complete clinical and laboratory data, and no medical condition that could affect NT‑proBNP or angiogenic marker levels between 2024 and 2025.
- Participants were classified into three groups: those with preeclampsia (n = 95; mean maternal age, 31.8 years), those with non-preeclampsia hypertensive disorders of pregnancy (n = 25; mean maternal age, 30.5 years), and healthy control individuals (n = 60; mean maternal age, 28.7 years).
- NT-proBNP levels and the sFlt-1/PlGF ratio were estimated during the second and third trimesters, and their associations with proteinuria, serum uric acid, serum creatinine, and maternal-foetal complications were assessed.
TAKEAWAY:
- Participants with preeclampsia had significantly higher median NT-proBNP levels than those with non-preeclampsia hypertensive disorders of pregnancy and healthy control individuals (210.0 vs 120.5 and 65.0 pg/mL; P < .05 for all).
- NT-proBNP levels were positively correlated with proteinuria (correlation coefficient [r], 0.45), serum creatinine (r, 0.41), uric acid (r, 0.38), and the sFlt-1/PlGF ratio (r, 0.42; P < .05 for all).
- An NT-proBNP level threshold of 200 pg/mL was independently associated with about threefold higher odds of maternal-foetal complications (adjusted odds ratio, 3.25; P = .005), with an area under the curve (AUC) of 0.78 (95% CI, 0.71-0.84), a sensitivity of 80%, and a specificity of 71% (P < .001).
- Combining NT‑proBNP with the sFlt‑1/PlGF ratio (AUC, 0.88; 95% CI, 0.82-0.92) improved risk discrimination over angiogenic sFlt‑1/PlGF testing alone (AUC, 0.84; 95% CI, 0.77-0.89).
IN PRACTICE:
“NT-proBNP could offer a practical and accessible tool to support earlier and more nuanced risk stratification in hypertensive pregnancy disorders. Even in settings where angiogenic testing is not readily available, elevated NT-proBNP levels may help clinicians recognize women who require closer surveillance, earlier referral, or more individualized care, ultimately contributing to safer management of high-risk pregnancies,” the authors wrote.
SOURCE:
This study was led by Diana Mocuta, Department of Obstetrics-Gynecology, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania. It was published online on January 08, 2026, in the Journal of Clinical Medicine.
LIMITATIONS:
The statistical power was limited by small subgroup numbers, particularly among women with hypertensive disorders of pregnancy without preeclampsia. NT‑proBNP and angiogenic markers were measured only once, preventing the assessment of changes over time. Laboratory procedures and batch-to-batch variability may have introduced measurement bias.
DISCLOSURES:
The article processing charge was funded by the University of Oradea, Oradea, Romania. The authors declared having no conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
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