Plasma Concentrations of N-Terminal Pro-B-Type Natriuretic Peptide in Pregnant Women near Labor and during Early Puerperium

摘要

B-Type natriuretic peptide (BNP) is considered an important component of the adaptive mechanism that helps reduce the load on the myocardium through systemic vasodilatation, reduction in venous return, and reduction in vascular volume (1). Plasma concentrations of BNP have been shown to reflect cardiac dysfunction and volume overload in adults and children (2)(3)(4). BNP is synthesized in cardiac myocytes as a prohormone, proBNP. The active hormone, BNP, is cleaved and cosecreted from the myocyte along with its N-terminal propeptide (NT-proBNP) (5). NT-proBNP concentrations have been shown to provide information similar to BNP, and the validity of the assay as a clinical tool is well documented (3)(6)(7)(8)(9).Pregnancy represents a state of physiologic volume expansion as maternal blood volume increases ～40%–45% above nonpregnancy volumes (10). Despite the growing data on the role of BNP in regulation of volume homeostasis, there are few studies regarding its role in pregnancy (11)(12)(13)(14). It has been shown that BNP concentrations are higher in preeclampsia and other hypertensive disorders of pregnancy than in normal pregnancy (11)(12)(14). It has also been suggested that BNP may have a role in regulation of amniotic fluid …