Biochemical markers of cardiac dysfunction in pregnancies with preeclampsia and fetal growth restriction

This study aimed to identify which subtypes of preeclampsia and fetal growth restriction (FGR) are associated with the greatest maternal cardiovascular strain, as indicated by laboratory biomarkers of cardiac dysfunction.

Women were recruited at diagnosis and serum levels of NT-proBNP, troponin T, and copeptin were analyzed. The cohort comprised 35 women with early-onset FGR, 54 with late-onset FGR, 53 with early-onset preeclampsia, and 29 with late-onset preeclampsia. Among preeclamptic patients, 58 had and 24 lacked concomitant FGR. Biomarkers were normalized for gestational age relative to uncomplicated pregnancies using Z-scores from log-transformed values.

All biomarkers showed a consistent pattern across pregnancy pathologies. The highest Z-scores for NT-proBNP (2.70, p < 0.001) and troponin T (3.25, p < 0.001) were found in early-onset preeclampsia, followed by preeclampsia with and without FGR, with no significant difference between these subgroups. Lower values occurred in late-onset preeclampsia and early-onset FGR, with the lowest in late-onset FGR.

All forms of preeclampsia and early-onset FGR demonstrated increased cardiovascular strain, whereas late-onset FGR showed minimal involvement. In preeclampsia, earlier disease manifestation was more closely associated with higher cardiovascular burden than concomitant FGR. Although cardiomarkers were elevated in pathological pregnancies, their utility for routine monitoring or postpartum follow-up appears limited.