MR-proANP, a cardiovascular biomarker in the prediction of late-onset preeclampsia and fetal growth restriction

Abstract Objectives Midregional pro atrial natriuretic peptide (MR-proANP) is a cardiac biomarker and the maternal serum levels could be different in preeclampsia (PE) or intrauterine growth restriction (IUGR) at third trimester of pregnancy. Methods This prospective study measured serum levels of MR-proANP between 32 and 37 weeks of pregnancy: 32 patients suffered from PE and 22 developed IUGR. 676 patients exhibited no pregnancy complications. Results The median level of MR-proANP was significantly higher in PE (64.9 pmol/l (interquartile range (IQR) 36.3-105.2) and IUGR (59.7 pmol/l (IQR 39.7- 163.0) groups compared to controls (38.7 pmol/l (IQR 29.7-49.2). Linear regression analysis showed association between PE and MR-proANP levels (Exp(s)= 1.56; 95% CI: 1.34-1.81). Area under the curve (AUC) estimates showed a predictive value for PE (AUC: 0.72) and IUGR (AUC: 0.71). Conclusions Measuring MR-proANP in maternal serum at third trimester could predict PE and IUGR presenting after 34 weeks of pregnancy. Thus, we assume that MR-proANP may be an additional biomarker which mirrors the maternal cardiosvascular status next to sFlt-1/PLGF representing the angiogenic status.