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Elevated B-type natriuretic peptide levels in pregnant women with hyperemesis gravidarum: a biomarker of cardiac stress?

Rev Assoc Med Bras (1992). 2025 Aug 8;71(7):e20242031. doi: 10.1590/1806-9282.20242031. eCollection 2025.

ABSTRACT

OBJECTIVE: The aim of this study was to evaluate serum B-type natriuretic peptide levels in pregnant women with hyperemesis gravidarum and compare them with healthy pregnant women.

METHODS: In this prospective cross-sectional study, sample size calculation using G*Power determined a minimum of 40 participants per group, totaling 80 participants. The study included 43 pregnant women with hyperemesis gravidarum and 43 healthy pregnant controls. Hyperemesis gravidarum diagnosis was based on clinical and laboratory criteria, including weight loss, ketonuria, and electrolyte imbalance. Exclusion criteria included pre-existing cardiovascular or systemic diseases, multiple pregnancies, and smoking. Serum B-type natriuretic peptide levels and various biochemical parameters were measured using standard laboratory techniques. Statistical analyses were performed using the Statistical Package for the Social Sciences software, with a p-value of <0.05 considered statistically significant.

RESULTS: B-type natriuretic peptide levels were significantly higher in the hyperemesis gravidarum group compared to the control group (HG: 9.6±2.5 pg/mL [95%CI 8.9-10.3]; control: 8.1±1.8 pg/mL [95%CI 7.5-8.6]; Cohen’s d=0.70, p=0.016). No significant differences were found between the groups in terms of age, body mass index, and other biochemical parameters, including hemoglobin, electrolytes, and inflammatory markers. B-type natriuretic peptide levels were not significantly correlated with gestational week, maternal age, body mass index, or hemoglobin levels.

CONCLUSION: In this study, we found that B-type natriuretic peptide levels are elevated in hyperemesis gravidarum, and we believe that this may be associated with increased cardiac stress. B-type natriuretic peptide may serve as a potential biomarker for monitoring cardiovascular changes in hyperemesis gravidarum. Further research is warranted to validate these findings and explore the role of B-type natriuretic peptide in the clinical management of hyperemesis gravidarum.

PMID:40802403 | DOI:10.1590/1806-9282.20242031

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