title: Effects of pre-eclampsia and fetal growth restriction on C-type natriuretic peptide.
abstract: OBJECTIVE
  To determine changes in plasma C-type natriuretic peptide (CNP), a paracrine product of the vascular endothelium, in pregnancies with vascular disorders, and relate these to time of presentation and severity.
  
  
  METHODS
  Retrospective nested cases and controls.
  
  
  METHODS
  Community study, Auckland New Zealand.
  
  
  METHODS
  Screening for Pregnancy Endpoints (SCOPE) data and bio-bank of maternal plasma.
  
  
  METHODS
  Maternal plasma amino terminal proCNP (NTproCNP) was measured by radioimmunoassay in early (14-16 weeks of gestation, and again at 19-21 weeks of gestation) and late (34-36 weeks of gestation) pregnancy in three groups of women (20 per group): pre-eclampsia (pre-eclampsia); gestational hypertension (GHT) with small for gestational age (SGA); and uncomplicated pregnancy.
  
  
  METHODS
  Change in NTproCNP and associations with concurrent blood pressure, time of case presentation, severity, and infant birthweight.
  
  
  RESULTS
  Plasma NTproCNP in early pregnancy in women with vascular disorders did not differ from those found in controls. In late pregnancy, levels in pre-eclampsia (28.8 ± 2.3 pM) and in GHT with SGA (28.6 ± 4.8 pM) were significantly increased (P = 0.01 and 0.027, respectively) compared with controls (21.3 ± 1 pM). In pre-eclampsia, levels were significantly higher (P < 0.03) at 14-16 weeks of gestation in women diagnosed prior to 34 weeks of gestation. Combining all three groups, associations of NTproCNP with concurrent diastolic and mean arterial pressure were found at 34-36 weeks of gestation (r = 0.46). No significant associations were identified with birthweight.
  
  
  CONCLUSIONS
  CNP secretion during gestation is responsive to vascular stress. Plasma NTproCNP measurements may have clinical application in late pregnancy in defining the different phenotypes associated with pre-eclampsia.
authors.affiliation: Department of Medicine, University of Otago, Christchurch, New Zealand.
authors.forename: E A
authors.initials: EA
authors.lastname: Espiner
authors.affiliation: Department of Medicine, University of Otago, Christchurch, New Zealand.
authors.forename: T C R
authors.initials: TC
authors.lastname: Prickett
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
authors.forename: R S
authors.initials: RS
authors.lastname: Taylor
authors.affiliation: Department of Obstetrics and Gynaecology, University of Otago, Christchurch, New Zealand.
authors.forename: R A
authors.initials: RA
authors.lastname: Reid
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
authors.forename: L M
authors.initials: LM
authors.lastname: McCowan
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001724:Birth Weight; D001794:Blood Pressure; D016022:Case-Control Studies; D005260:Female; D005317:Fetal Growth Retardation / Q000097:blood* / Q000503:physiopathology / Q000517:prevention & control; D006801:Humans; D007236:Infant, Small for Gestational Age; D020098:Natriuretic Peptide, C-Type / Q000097:blood*; D009520:New Zealand; D010641:Phenotype; D011225:Pre-Eclampsia / Q000097:blood* / Q000503:physiopathology / Q000517:prevention & control; D011247:Pregnancy; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D020098:Natriuretic Peptide, C-Type
keywords: Fetal growth restriction; NTproCNP; hypertension; pre-eclampsia; pregnancy; small for gestational age