en بررسی ارتباط سطح سرمی Pro-BNP NT در مادران باردار مبتلا به بیماری قلبی با عوارض مادری و جنینی: یک مطالعه کوهورت Pregnancy Health Original Article Original Article <div style="text-align: justify;"><span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مقدمه: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">بیماری‌های قلبی در 4-1% از بارداری‌ها رخ داده و با عوارض جدی همراه هستند. شیوع این بیماری‌ها به دلایلی مانند چاقی، فشار خون بالا، دیابت و افزایش سن مادر در حال افزایش است. </span></span><span dir="LTR" style="font-size:10.0pt">NT-proBNP</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> به دلیل نیمه‌عمر طولانی، نشانگر زیستی مناسبی برای ارزیابی توانایی قلب در تطبیق با تغییرات همودینامیکی بارداری محسوب می‌شود.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">هدف: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">هدف<b> </b>بررسی ارتباط سطح سرمی </span></span><span dir="LTR" style="font-size:10.0pt">NT-proBNP</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> در مادران باردار مبتلا به بیماری‌های قلبی با عوارض بارداری و زایمان بود.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مواد و روش&shy; ها: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">این مطالعه آینده&shy;نگر روی 50 زن باردار مبتلا به بیماری&shy;های قلبی<b> </b>در بیمارستان امام رضا (ع) مشهد طی سال‌های 1399-1398 انجام شد.<b> </b>50 زن باردار در سه سوم ماهه بارداری که مبتلا به بیماری‌های قلبی-عروقی (دارای کلاس 2 یا بالاتر انجمن قلب نیویورک) بودند، وارد مطالعه شدند. بر اساس سطح </span></span><span dir="LTR" style="font-size:10.0pt">NT-proBNP</span><span style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> شرکت&shy;کنندگان بر اساس حد آستانه </span></span><span dir="LTR" style="font-size:10.0pt">pg/ml</span><span style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> 125 به گروه&shy;های نرمال (37 نفر) و بالا (13 نفر) تقسیم شدند. عوارض جنینی-مادری ارزیابی و تجزیه و تحلیل شد.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نتایج: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">سطح بالای </span></span><span dir="LTR" style="font-size:10.0pt">NT-proBNP</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> با آپگار پایین نوزاد (049/0 </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) و افزایش فشار خون در ویزیت‌های دوم (049/0 </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) و سوم (0001/0 </span></span><span lang="FA" style="font-size:10.0pt">> </span><span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) ارتباط معناداری داشت. تفاوت معناداری در سابقه مصرف دارو (013/0 </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) بین گروه</span></span><span dir="LTR" style="font-size:11.0pt"><span arial="" style="font-family:">&shy;</span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">ها مشاهده شد. با این حال هیچ تفاوت معناداری در سایر متغیرها، از جمله پذیرش در بخش مراقبت</span></span><span dir="LTR" style="font-size:11.0pt"><span arial="" style="font-family:">&shy;</span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">های ویژه/بخش مراقبت ویژه نوزادان، روش زایمان، یافته</span></span><span dir="LTR" style="font-size:11.0pt"><span arial="" style="font-family:">&shy;</span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">های الکتروکاردیوگرافی یا نتایج اکوکاردیوگرافی مشاهده نشد (05/0 </span></span><span lang="FA" style="font-size:10.0pt">> </span><span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">).</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial",sans-serif"></span></span></span></span></span></span></span><br> <b><span dir="RTL" lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نتیجه&shy; گیری: </span></span></b><span dir="RTL" lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">سطح بالای </span></span><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">NT-proBNP</span></span><span dir="RTL" lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> می‌تواند نشان‌دهنده‌ی افزایش خطر فشار خون بارداری و آپگار پایین نوزاد باشد و در پایش مادران باردار مبتلا به بیماری‌های قلبی مفید است</span></span><span style="font-size:11.0pt"><span arial="" style="font-family:">.</span></span></div> <div style="text-align: justify;"><span style="font-family:Times New Roman;"><span style="font-size:12pt"><span new="" roman="" times=""><strong>Background:</strong> Heart diseases affect 1-4% of pregnancies, leading to fetomaternal complications. Brain natriuretic peptide is a key biomarker for assessing cardiac adaptation to pregnancy-related hemodynamic changes. The longer half-life of its terminal fragment, N terminal pro brain natriuretic peptide (NT-ProBNP), increases its diagnostic utility.</span></span><br> <span style="font-size:12pt"><span new="" roman="" times=""><strong>Objective:</strong> This study aimed to evaluate the association between NT-proBNP serum levels and fetomaternal complications in pregnant women with cardiovascular disease.</span></span><br> <span style="font-size:12pt"><span new="" roman="" times=""><strong>Materials and Methods:</strong> A prospective longitudinal study was conducted at the Cardiology and Obstetrics Clinic of Imam Reza hospital, Mashhad, Iran, from July 2019-July 2020. 50 pregnant women in their third trimester with cardiovascular disease (New York Heart Association class 2 or higher) were included. Based on NT-proBNP levels, participants were categorized into normal (n = 37) and elevated (n = 13) groups using a 125 pg/ml cutoff. Fetomaternal complications were assessed and analyzed.</span></span><br> <span style="font-size:12pt"><span new="" roman="" times=""><strong>Results:</strong> Elevated NT-proBNP levels were significantly associated with increased hypertension in the second (p = 0.05) and third (p < 0.0001) visits and low Apgar scores (p = 0.05). A significant difference in drug history (p = 0.013) was observed between the groups. However, no significant differences were found in other variables, including intensive care unit)/neonatal intensive care unit admission, mode of delivery, electrocardiography findings, or echocardiographic results (p > 0.05).</span></span><br> <b><span style="font-size:11.0pt"><span style="line-height:115%"><span new="" roman="" times="">Conclusion:</span></span></span></b> <span style="font-size:11.0pt"><span style="line-height:115%"><span new="" roman="" times="">Elevated NT-proBNP levels are strongly linked to hypertension during pregnancy and low neonatal Apgar scores, highlighting its potential as a predictive biomarker for fetomaternal risk assessment.</span></span></span></span></div> بارداری, بیماری قلبی-عروقی, NT-ProBNP, عوارض مادری-جنینی. Pregnancy, Cardiovascular disease, NT-proBNP, Fetomaternal complications. 749 758 http://ijrm.ir/browse.php?a_code=A-10-2539-1&slc_lang=en&sid=1 Zahra Hatamian zh.hatamian@gmail.com 0009-0002-4349-7005 No Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Seyede Houra Mousavi Vahed vahedalainh@mums.ac.ir 0000-0002-8978-2605 Yes Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Farveh Vakilian vakilianf@mums.ac.ir 0000-0002-7514-6683 No Department of Cardiology, Faculty of Medicine, Lung Diseases Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. Hoorak Poorzand poorzandh@mums.ac.ir 0000-0002-0764-6563 No Department of Cardiology, Faculty of Medicine, Vascular and Endovascular Surgery Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. Marzieh Lotfalizade lotfalizadem@mums.ac.ir 0000-0002-7475-6252 No Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Nahid Zirak zirakn@mums.ac.ir 0000-0002-6488-3039 No Department of Anesthesiology, Faculty of Medicine, Lung Diseases Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. Hassan Mehrad Majd mehradmajdh@mums.ac.ir 0000-0002-8745-6558 No Department of Medical Genetics and Molecular Medicine, Faculty of Medicine, Cancer Molecular Pathology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Marzieh Nozari nozarim1@mums.ac.ir 0009-0007-1853-3074 No Department of Midwifery, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran. Salmeh Dadgar dadgars@mums.ac.ir 0000-0001-6355-0622 No Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Malihe Afiat afiatm@mums.ac.ir 0000-0001-9630-6490 No Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.