{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T16:30:50Z","timestamp":1789144250712,"version":"build-2803163510"},"reference-count":41,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,11,8]],"date-time":"2025-11-08T00:00:00Z","timestamp":1762560000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>N\u2010terminal pro\u2010B\u2010type natriuretic peptide (NT\u2010proBNP), a marker of cardiac stress, has been proposed as a potential prognostic biomarker for maternal adverse outcome in pre\u2010eclampsia (PE). This study aimed to evaluate the predictive value of NT\u2010proBNP for severe maternal adverse outcome in pregnancies with an established diagnosis of PE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This was a retrospective cohort study of singleton pregnancies diagnosed with PE \u2264\u200936\u2009weeks of gestation that were assessed at the Medical University of Vienna between January 2018 and December 2023. Maternal serum levels of NT\u2010proBNP, soluble fms\u2010like tyrosine kinase\u20101 (sFlt\u20101) and placental growth factor (PlGF) were measured at the time of PE diagnosis. The primary outcome was the occurrence of a severe maternal adverse event, including intensive care unit admission, maternal death, pulmonary edema and severe neurological complications. Associations between severe maternal adverse outcome and\n                      <jats:italic>Z<\/jats:italic>\n                      \u2010scores for NT\u2010proBNP and the sFlt\u20101\/PlGF ratio were analyzed using logistic and Cox regression models adjusted for gestational age at sampling and the\n                      <jats:italic>Z<\/jats:italic>\n                      \u2010score of the other biomarker. The area under the receiver\u2010operating\u2010characteristics (ROC) curve (AUC) was used to assess the discriminative ability of the biomarkers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 130 women included in our cohort, 13 (10%) experienced severe maternal adverse outcome. NT\u2010proBNP levels were significantly higher in this group (median, 688.0 (interquartile range (IQR), 249.6\u20131038.0)\u2009pg\/mL\n                      <jats:italic>vs<\/jats:italic>\n                      106.1 (IQR, 50.6\u2013280.6)\u2009pg\/mL;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Higher NT\u2010proBNP\n                      <jats:italic>Z<\/jats:italic>\n                      \u2010score was associated significantly with severe maternal adverse outcome (adjusted odds ratio, 3.24 (95%\u2009CI, 1.50\u20137.84);\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.005) and predicted shorter time\u2010to\u2010delivery with severe maternal adverse outcome\u00a0(adjusted hazard ratio, 3.08 (95%\u2009CI, 1.47\u20136.44);\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.003) after adjusting for gestational age at sampling and sFlt\u20101\/PlGF ratio\n                      <jats:italic>Z<\/jats:italic>\n                      \u2010score. The sFlt\u20101\/PlGF ratio was not associated significantly with these outcomes. ROC\u2010curve analysis showed that NT\u2010proBNP had superior discriminative performance compared with the sFlt\u20101\/PlGF ratio (AUC, 0.75 (95%\u2009CI, 0.61\u20130.90)\n                      <jats:italic>vs<\/jats:italic>\n                      0.67 (95%\u2009CI, 0.56\u20130.79)). The performance of both biomarkers improved when combined with gestational age at sampling (AUC, 0.82 (95%\u2009CI, 0.71\u20130.94)\n                      <jats:italic>vs<\/jats:italic>\n                      0.76 (95%\u2009CI, 0.65\u20130.88)).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      NT\u2010proBNP was a strong predictor of severe maternal adverse outcome and time\u2010to\u2010delivery in women diagnosed with PE, especially in early\u2010onset cases. NT\u2010proBNP may serve as a clinically accessible biomarker for risk stratification and surveillance in women with established PE. \u00a9 2025 The Author(s).\n                      <jats:italic>Ultrasound in Obstetrics &amp; Gynecology<\/jats:italic>\n                      published by John Wiley &amp; Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.70129","type":"journal-article","created":{"date-parts":[[2025,11,9]],"date-time":"2025-11-09T06:58:57Z","timestamp":1762671537000},"page":"754-761","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Prognostic value of maternal N\u2010terminal pro\u2010B\u2010type natriuretic peptide for prediction of severe maternal adverse outcome in women with 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