Abstract
Objective
To examine the correlation of cardiac B-type natriuretic peptide (BNP) concentrations
in umbilical cord blood at birth with fetal Doppler parameters and pH at birth.
Study design
Prospective cross-sectional study with the following inclusion criteria: women with
a singleton pregnancy, placental insufficiency characterized by increased pulsatility
index (PI) of the umbilical artery (UA), intact membranes, and absence of fetal abnormalities.
The exclusion criteria kept out cases of newborns with postnatal diagnosis of abnormality
and cases in which the blood analysis was not performed. The Doppler parameters used
were the UA PI, middle cerebral artery (MCA) PI, cerebroplacental ratio (CPR), and
ductus venosus (DV) PI for veins (PIV), all converted into zeta scores. Blood samples
were obtained from the umbilical cord immediately after delivery to measure the pH
of the UA and the BNP.
Results
Thirty-two pregnancies with placental insufficiency were included, 21 (65%) with positive
diastolic flow and 11 (35%) with absent or reversed end diastolic flow in the UA.
The concentration of BNP correlated significantly with the UA PI z-score (rho = 0.43, P = 0.016), the CPR z-score (rho = −0.35, P = 0.048), the DV PIV z-score (rho = 0.61, P < 0.001), pH at birth (rho = −0.39, P = 0.031), and gestational age (rho = −0.51, P = 0.003). In the multiple regression analysis, antenatal parameters were included; the
DV PIV z-score (P = 0.008) was found to be an independent parameter correlating with BNP at birth. Correlation
between BNP and the DV PIV z-score was borne out by the regression equation Log[BNP] = 2.34 + 0.13*DV (F = 18.8, P < 0.001). Correlation between BNP and pH at birth was confirmed by the regression equation
Log[BNP] = 21.36–2.62*pH (F = 7.69, P = 0.01).
Conclusion
The results suggest that fetal cardiac dysfunction identified by BNP concentrations
at birth correlated independently with changes in DV PIV and correlated negatively
with pH values at birth.
Keywords
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Article info
Publication history
Published online: September 16, 2013
Accepted:
September 2,
2013
Received in revised form:
July 18,
2013
Received:
March 8,
2013
Identification
Copyright
© 2013 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
