title: N-terminal pro-B-type natriuretic peptide predicts cardiovascular complications in pregnant women with congenital heart disease.
abstract: OBJECTIVE
  In women with congenital heart disease (CHD), cardiovascular complications during pregnancy are common, but the risk assessment of these patients remains difficult. This study sought to determine the independent role of N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels in addition to other parameters in predicting adverse cardiovascular events during pregnancy in women with CHD.
  
  
  RESULTS
  We conducted a national, prospective multicentre cohort study. Follow-up with clinical evaluation and echocardiography and NT-proBNP measurement was performed at 20-week gestation. Adverse cardiovascular events occurred in 10.3% of 213 pregnancies. N-terminal pro-B-type natriuretic peptide levels >128 pg/mL at 20-week gestation, the presence of a mechanical valve, and subpulmonary ventricular dysfunction before conception were independently associated with events [odds ratio (OR) 10.6 (P = 0.039), OR 12.0 (P = 0.016), and OR 4.2 (P = 0.041), respectively]. The negative predictive value of NT-proBNP levels <128 pg/mL was 96.9%. N-terminal pro-B-type natriuretic peptide levels >128 pg/mL at 20 weeks of gestation had an additional value in predicting the occurrence of adverse cardiovascular events on the top of the other identified predictors (area under the curve 0.90 vs. 0.78, P = 0.035).
  
  
  CONCLUSIONS
  Increased NT-proBNP levels at 20 weeks of gestation are an independent risk predictor of cardiovascular events during pregnancy in women with CHD.
authors: Department of Cardiology, Thorax Centre, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9700RB, The Netherlands.
authors: Marlies A M
authors: MA
authors: Kampman
authors: Ali
authors: A
authors: Balci
authors: Dirk J
authors: DJ
authors: van Veldhuisen
authors: Arie P J
authors: AP
authors: van Dijk
authors: Jolien W
authors: JW
authors: Roos-Hesselink
authors: Krystyna M
authors: KM
authors: Sollie-Szarynska
authors: Marieke
authors: M
authors: Ludwig-Ruitenberg
authors: Joost P
authors: JP
authors: van Melle
authors: Barbara J M
authors: BJ
authors: Mulder
authors: Petronella G
authors: PG
authors: Pieper
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications*; D006801:Humans; D020097:Natriuretic Peptide, Brain / Q000378:metabolism*; D010446:Peptide Fragments / Q000378:metabolism*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis* / Q000628:therapy; D011295:Prenatal Care; D011296:Prenatal Diagnosis; D011446:Prospective Studies
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Congenital heart disease; Natriuretic peptides; Pregnancy; Right ventricular function