High Serum Adrenomedullin and Mid-Regional Pro-Atrial Natriuretic Peptide Concentrations in Early Pregnancy Predict the Development of Gestational Hypertension

Abstract

Objectives: Adrenomedullin (AM) and natriuretic peptide levels are elevated in pre-eclampsia. The aim of the present study was to determine AM and natriuretic peptide concentrations before 20 weeks of pregnancy in women who later developed gestational hypertension and in normal pregnancies. Methods: 95 pregnant Caucasian women were included in the study. Gestational hypertension (GH) was diagnosed in 18 patients. The control group consisted of 41 patients with normal pregnancies (non-GH). Blood samples were taken during the first trimester of pregnancy. Results: Analysis of NT-proBNP showed no significant differences between the group of patients who later developed GH and those with normal pregnancies. Patients who developed GH later in pregnancy had higher levels of both MR-proANP (p < 0.001) and adrenomedullin (p < 0.001). Higher levels of MR-proANP were found in the GH with pre-eclampsia group compared with the GH without pre-eclampsia group. Higher levels of AM (p < 0.05) and MR-proANP (p < 0.005) correlated with the risk of preterm birth. Conclusions: (1) Plasma adrenomedullin and MR-proANP concentrations were higher before the 20th week of pregnancy in women who later developed GH; (2) NT-proBNP concentrations did not differ between women with pregnancy-induced hypertension and normal pregnancies; (3) MR-proANP concentrations were highest in patients who developed pre-eclampsia in advanced pregnancy; and (4) there was a correlation between higher plasma adrenomedullin, MR-proANP concentrations before the 20th week of pregnancy, and the risk of preterm birth.