N-terminal pro B-type natriuretic peptide and angiogenic biomarkers in the prognosis of adverse outcomes in women with suspected preeclampsia

•NT-proBNP levels are increased in women who are about to develop preeclampsia.•The sFlt-1/PlGF ratio is the most useful biomarker in the management of preeclampsia.•NT-proBNP and sFlt-1/PlGF ratio can predict the development of adverse outcomes.

BackgroundThis study compares the performance of the soluble fms-like tyrosine kinase 1 to placental growth factor (sFlt-1/PlGF) ratio and the cardiac biomarker N-terminal pro-B type natriuretic peptide (NT-proBNP) in the prediction of adverse outcomes in women with suspicion of PE.MethodsA retrospective cohort study was conducted on women admitted at triage with signs and/or symptoms of PE (n = 340). Serum levels of sFlt-1, PlGF and NT-proBNP were determined by an electrochemiluminescence immunoassay (Roche Diagnostics). The main outcomes were early- or late-onset PE and development of adverse outcome, defined as delivery within the first week since clinical presentation or fetal/early neonatal death.ResultsNT-proBNP concentrations (ng/L) were significantly increased in PE versus non-PE women, both at < 34 (169 versus 34) and ≥ 34 weeks of gestation (101 versus 49) (p < 0.001). A cut-point of 70 showed sensitivities/specificities of 78/74% for early-, and 70/62% for late-onset PE; slightly lower than those offered by the sFlt-1/PlGF ratio or uric acid. The respective cut-points of 178 and 219 for sFlt-1/PlGF ratio and NT-proBNP, demonstrated similar performance in the prediction of adverse outcome, with sensitivity/specificity of 95/84% and 94/76%, respectively.ConclusionNT-proBNP and sFlt-1/PlGF ratio can be used to predict the development of an adverse outcome.