Effects of caesarean section on serum levels of NT‐proBNP. (25th January 2013)

• Record Type: Journal Article
• Authors: Yamada, Takashi; Koyama, Takahiro; Furuta, Itsuko; Takeda, Masamitsu; Nishida, Ryutaro; Yamada, Takahiro; Morikawa, Mamoru; Minakami, Hisanori
• Is Part Of: Clinical endocrinology. Volume 78:Number 3(2013:Mar.)
• Page Start: 460
• Page End: 465
• Publication Date: 2013-01-25
• Subjects: Endocrinology -- Periodicals; 616.4005
• DOI: 10.1111/j.1365-2265.2012.04511.x
• Languages: English
• ISSNs: 0300-0664

Abstract

<abstract abstract-type="main" id="cen4511-abs-0001"> <title>Summary</title> <sec id="cen4511-sec-0001" sec-type="section"> <title>Objective</title> <p>To determine the effects of delivery by caesarean on serum levels of N‐terminal fragment of precursor protein brain‐type natriuretic peptide (NT‐proBNP).</p> </sec> <sec id="cen4511-sec-0002" sec-type="section"> <title>Methods</title> <p>Serum NT‐proBNP levels were determined longitudinally at 24 and 36 weeks of gestation (GW) and on post‐partum day 3 and month 1 (PPD3 and PPM1, respectively) in 78 women with normotensive singleton pregnancies. Thirty‐nine women underwent caesarean delivery. Plasma renin activity (PRA) and plasma aldosterone concentration (PAC) were determined on PPD3. Effects of maternal demographic characteristics on NT‐proBNP levels were also analysed.</p> </sec> <sec id="cen4511-sec-0003" sec-type="section"> <title>Results</title> <p>NT‐proBNP levels (pg/ml) either in pregnancy or on PPM1 did not differ between women with vaginal and caesarean deliveries (44 ± 24 <italic>vs</italic> 41 ± 30, 24 GW; 37 ± 22 <italic>vs</italic> 29 ± 22, 36 GW; 43 ± 28 <italic>vs</italic> 39 ± 24, PPM1, respectively). Levels on PPD3 were significantly higher (94 ± 105 <italic>vs</italic> 247 ± 186, <italic>P </italic><<italic> </italic>0·0001) in women with caesarean delivery. Among women with caesarean delivery, a larger rise of NT‐proBNP on PPD3 occurred in nulliparous than in multiparous women (319 ± 232 <italic>vs</italic> 185 ± 107, <italic>P </italic>=<italic> </italic>0·023), while no rise occurred among multiparous women with vaginal delivery (108 ± 115 <italic>vs</italic> 47 ± 27). NT‐proBNP levels on PPD3 were significantly and negatively correlated with PRA, PAC and maternal weight loss after childbirth on PPD3. These 3 variables on PPD3 were significantly lower in women undergoing caesarean than vaginal delivery (0·8 ± 0·4 <italic>vs</italic> 1·9 ± 1·4 ng/ml/h for PRA; 70 ± 38 <italic>vs</italic> 136 ± 88 pg/ml for PAC; 2·7 ± 1·2 <italic>vs</italic> 4·3 ± 1·1 kg for weight loss, each <italic>P </italic><<italic> </italic>0·0001).</p> </sec> <sec id="cen4511-sec-0004" sec-type="section"> <title>Conclusions</title> <p>The transient post‐partum rise in serum NT‐proBNP may reflect transient volume overload after parturition and is remarkable in nulliparous women, especially after caesarean section.</p> </sec> </abstract>