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Poster Session 2

(615) Association between NT-proBNP and persistent postpartum hypertension among individuals with hypertensive disorders of pregnancy

Thursday, January 30, 2025
4:00 PM – 6:00 PM  

    Submitting Author and Presenting Author(s)

  • Rosemary Shay, MD

    MFM Fellow
    University of Pittsburgh Medical Center
    Pittsburgh, Pennsylvania, United States

    • Coauthor(s)

  • Carrie Bennett, MD

    Maternal-Fetal Medicine Fellow
    University of Pittsburgh Medical Center
    Pittsburgh, Pennsylvania, United States

  • Caroline Smith, BA (she/her/hers)

    University of Pittsburgh School of Medicine
    Pittsburgh, Pennsylvania, United States

  • JC

    Janet Catov, MS, PhD

    Professor, Department of Obstetrics, Gynecology & Reproductive Sciences
    Magee-Womens Hospital
    Pittsburgh, Pennsylvania, United States

  • Arun Jeyabalan, MD, MS (she/her/hers)

    Division Director of Maternal-Fetal Medicine
    University of Pittsburgh School of Medicine
    Pittsburgh, Pennsylvania, United States

  • RG

    Robin E. Gandley, PhD

    Magee-Womens Research Institute
    Pittsburgh, Pennsylvania, United States

  • MC

    Malamo Countouris, MD

    Assistant Professor of Medicine, Department of Cardiology
    University of Pittsburgh Medical Center
    Pittsburgh, Pennsylvania, United States

  • Alisse Hauspurg, MD (she/her/hers)

    Assistant Professor
    Alpert Medical School of Brown University
    Providence, RI, United States

Objective: Natriuretic peptide (NP) concentrations are increased in hypertensive disorders of pregnancy (HDP), but the association of NP levels with postpartum outcomes among hypertensive individuals has not been well explored. Our objective was to evaluate the association of N-terminal pro B-type natriuretic peptide (NT-proBNP) concentration at delivery with persistent postpartum hypertension (HTN) and blood pressure (BP) trajectory in the first two weeks postpartum among individuals with HDP.



Study Design: This cohort study included individuals with new-onset HDP (gestational hypertension, preeclampsia) who participated in a remote BP monitoring program and an obstetric biobank. NT-proBNP was measured from maternal plasma at delivery. Postpartum BP data were collected from delivery hospitalization, six-week remote BP program, and outpatient visits. Outcomes were compared between low-NT-proBNP (< 150 pg/mL) and high-NT-proBNP (≥150 pg/mL) groups, with cut-off of 150 pg/mL based on previously published reference intervals in pregnancy. We used repeated BP measures to fit mixed-effects linear regression models using restricted cubic splines. Persistent HTN was defined as BP ≥140/90 mmHg or antihypertensive medication.



Results: Of 111 individuals with HDP, 31 (28%) had low NT-proBNP, and 80 (72%) had high NT-proBNP. Those with high NT-proBNP had higher maximum DBP during the delivery hospitalization (101 vs. 94 mmHg, p=0.01), higher maximum SBP during remote monitoring (145 vs. 139 mmHg, p=0.049), and higher likelihood of being on antihypertensives at any time postpartum (49% vs. 23%, p=0.01) compared with those with low NT-proBNP. High NT-proBNP was associated with persistent HTN at six weeks postpartum (40% vs. 19%, p=0.04) compared with low NT-proBNP. The high-NT-proBNP group had a significantly different SBP trajectory from the low-NT-proBNP group over the first two weeks postpartum (p=0.04 for SBP, p=0.13 for DBP).



Conclusion: Individuals with elevated NT-proBNP may be at increased risk for ongoing HTN in the postpartum period and could warrant closer monitoring after delivery.
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