natriuretic-peptide--brain and Fetal-Distress

To evaluate fetal cardiopulmonary stress in pregnancies complicated by preeclampsia (PE), fetal growth restriction (FGR), preterm birth (PT), and fetal distress (FD) using umbilical arterial blood N-terminal pro-B-type natriuretic peptide (NT-proBNP).. The study included 146 blood samples that were drawn from umbilical arteries at the time of delivery (20 cases of PE, 11 cases of FGR, 31 cases of PT, 23 cases of FD, and 61 cases of gestational age-matched controls) and analyzed. The main outcome measures included neonatal birthweight, cord pH, and umbilical arterial NT-proBNP.. The umbilical arterial NT-proBNP levels were significantly higher in the PE, FGR, PT, and FD groups than in the control group. The umbilical arterial NT-proBNP levels were negatively correlated with gestational age, birthweight, and umbilical arterial pH.. Umbilical arterial NT-proBNP levels are elevated in stressful fetal conditions and have the potential to be considered as a marker for fetal cardiopulmonary stress.

Topics: Adult; Biomarkers; Birth Weight; Female; Fetal Blood; Fetal Distress; Fetal Growth Retardation; Gestational Age; Humans; Infant, Newborn; Natriuretic Peptide, Brain; Peptide Fragments; Pre-Eclampsia; Pregnancy; Premature Birth; Prospective Studies; Umbilical Arteries

To investigate whether no asphyxia neonates with intrauterine distress are complicated with myocardial injury and determine the sensitive biochemical diagnostic parameters.. A total of 89 neonates born in the First Affiliated Hospital of Sun Yat-sen University from July 2009 to December 2009 were enrolled. Fifty-three fetal distress cases with Apgar score > 7 at 1 and 5 minutes were enrolled in the study group; while the rest 36 healthy neonates, whose Apgar score = 10 at 1 and 5 minutes, were the control group. Umbilical artery blood samples of all cases were collected for blood gas analysis and biochemical measurement.. (1) pH (7.23 ± 0.07) and BE [(-4.8 ± 3.0) mmol/L] in the study group were significantly lower than pH (7.31 ± 0.03) and BE [(-2.1 ± 1.5) mmol/L ] in the control group(P < 0.05). The lactic acid of study group [(5.2 ± 2.3) mmol/L] was higher than that of the control group [(2.3 ± 1.1) mmol/L], and the difference was significant (P < 0.01). However, there was no significant difference between the two groups in PaO2 [(16.2 ± 7.9) mm Hg (1 mm Hg = 0.133 kPa) vs. (17.5 ± 6.7) mm Hg] and PaCO2 [(54.0 ± 11.2) mm Hg vs. (48.5 ± 5.4) mm Hg; P > 0.05]. (2) The level of CK-MB in neonates with fetal distress[ (48 ± 59) U/L] was significantly higher than that of healthy neonates [(36 ± 27) U/L]. However, no significant difference was found in CK [(194 ± 73) U/L vs. (162 ± 95) U/L] and BNP levels [(519 ± 309) ng/L vs. (481 ± 216) ng/L; P > 0.05]. (3) Spearman rank correlation analysis showed that CK-MB level was negatively correlated with pH (r = -0.296, P < 0.05) and BE (r = -0.318, P < 0.05) of umbilical artery blood, while BNP level was positively correlated with umbilical lactic acid (r = 0.278, P < 0.05). No correlation was found between other parameters (P > 0.05).. Intrauterine distress without neonatal asphyxia had effect on fetal myocardial injury. CK-MB can be used as a sensitive parameter for monitoring the development of myocardial injury. The severity of myocardial injury was related to fetal acidosis.

Topics: Adult; Apgar Score; Biomarkers; Blood Gas Analysis; Case-Control Studies; Creatine Kinase; Creatine Kinase, MB Form; Female; Fetal Distress; Heart Injuries; Humans; Hydrogen-Ion Concentration; Infant, Newborn; Isoenzymes; Male; Myocardium; Natriuretic Peptide, Brain; Umbilical Arteries

We measured, by a specific radioimmunoassay, brain-natriuretic-peptide-like immunoreactive (BNP-LI) levels in the umbilical venous and arterial plasma of normal and distressed newborns. The indicated BNP-LI level in umbilical arterial plasma of normal newborns (3.5 +/- 0.9 fmol/ml, mean +/- SEM, n = 10) was significantly higher than that in umbilical venous plasma of the same newborns (2.2 +/- 0.5 fmol/ml). In the distressed newborns at term, the indicated BNP-LI level in umbilical venous plasma was 62.2 +/- 25.7 fmol/ml (n = 4), which was 19-fold higher than that of elective cesarean section cases (3.2 +/- 0.3 fmol/ml, n = 6; p < 0.05). The findings demonstrated that BNP was present in the human fetal circulation and that the plasma BNP level was elevated under fetal distress conditions.

Topics: Atrial Natriuretic Factor; Cesarean Section; Chromatography, Gel; Delivery, Obstetric; Female; Fetal Blood; Fetal Distress; Humans; Infant, Newborn; Natriuretic Peptide, Brain; Nerve Tissue Proteins; Pregnancy; Radioimmunoassay; Reference Values; Umbilical Arteries; Umbilical Veins

Topics: Atrial Natriuretic Factor; Female; Fetal Blood; Fetal Distress; Humans; Natriuretic Peptide, Brain; Nerve Tissue Proteins; Pregnancy