304 Published by Bali Medical Journal | Bali Medical Journal 2021; 10(1): 304-308 | doi: 10.15562/bmj.v10i1.2162 ORIGINAL ARTICLE ABSTRACT Serum N-Terminal Pro B-Type Natriuretic Peptide is associated with maternal complication in pregnancy with severe preeclampsia Alini Hafz 1* , Julian Dewantiningrum 1 , Herman Kristanto 1 , M. Besari Adi Pramono 1 Background: Hypertension is the second most common cause of maternal death in the world. Predicting the occurrence of preeclampsia (PE) complications is needed to optimize management. Brain natriuretic peptide (BNP) is a polypeptide, secreted by cardiac ventricular myocytes. Research linking N-Terminal Pro B-Type Natriuretic Peptide (NT-proBNP) levels with maternal complications has never been conducted in Indonesia. The aim of the study is to evaluate plasma NT-proBNP levels in pregnant women with pre-eclampsia and normotension and to fnd a relationship between NT-proBNP levels and maternal complications incidence. Methods: This cross sectional study was conducted on thirty women with severe preeclampsia with gestational age >20 weeks who attended and underwent labor at Dr. Kariadi Hospital Semarang during study period. Patients with a history of chronic disease, underweight or obese, history of heart disease and consumption of heart drugs were excluded. Serum NT-proBNP was taken prior labor. Correlation between NT-proBNP serum levels and physical characteristics as well as complications was performed using the Mann-Whitney and Spearman correlation test. Results: NT-proBNP serum levels were signifcantly higher in the severe preeclampsia group, especially early-onset compared to the normotensive group (p<0.05). Increased serum NT-proBNP levels are associated with several maternal complications, especially HELLP syndrome, pulmonary edema, retinopathy and renal impairment. Conclusions: Increased serum NT-proBNP levels are associated with severe preeclampsia and several maternal complications. Keywords: preeclampsia, NT-proBNP, maternal complications. Cite This Article: Hafz, A., Dewantiningrum, J., Kristanto, H., Pramono, M.B.A. 2021. Serum N-Terminal Pro B-Type Natriuretic Peptide is associated with maternal complication in pregnancy with severe preeclampsia. Bali Medical Journal 10(1): 304-308. DOI: 10.15562/bmj.v10i1.2162 1 Departement of Obstetrics and Gynecology, Faculty of Medicine, Universitas Diponegoro–Dr. Kariadi General Hospital Semarang, Indonesia. *Corresponding author: Alini Hafz; Departement of Obstetrics and Gynecology, Faculty of Medicine, Universitas Diponegoro–Dr. Kariadi General Hospital Semarang, Indonesia; alini.erlangga@gmail.com Received: 2020-12-31 Accepted: 2021-04-20 Published: 2021-04-30 304 Published by Bali Medical Journal Bali Medical Journal (Bali MedJ) 2021, Volume 10, Number 1: 304-308 P-ISSN.2089-1180, E-ISSN: 2302-2914 Open access: www.balimedicaljournal.org BACKGROUNDS Hypertensive disorders in pregnancy cause about 30% of maternal deaths. 1 According to World Health Organization, hypertension accounts for 14% of global maternal mortality and global second most common cause of maternal mortality. 2 Preeclampsia is a serious medical problem with high complexity. Severe preeclampsia can lead to life-threatening maternal complications including eclamptic seizures, HELLP syndrome, placental abruption, acute cardiovascular complications and pulmonary edema. Predicting the occurrence of preeclampsia complications is needed to optimize proper management, thus preventing maternal and infant morbidity and mortality. Various biomarkers are increased in preeclamptic women, including Corin, LDH, leptin, PAPP-A, inhibin and activin A, cystatin C, beta 2 microglobulins, beta-trace protein, sFlt- 1/PGF ratio, BNP and NT-proBNP. 3-10 Although there are various potential markers for preeclampsia, the reliability of these markers for predicting the severity and complication of preeclampsia was inconsistent between studies. Brain natriuretic peptide (BNP) is a polypeptide, secreted as N-Terminal pro BNP (NT-proBNP) by cardiac ventricular myocytes in response to excessive myocardial stretch and further broken down into active BNP hormones and biologically inactive NT-proBNP. 11,12 NT-proBNP levels are found to be higher in preeclampsia due to an increase in aferload that coincides with a pre-existing excessive volume increase and a decrease in NT-proBNP metabolic clearance due to renal impairment. Tere has not been any research linking NT-proBNP levels with maternal complications in Indonesia. Tis study will evaluate plasma NT-proBNP levels in preeclampsia and normotension women and evaluate the correlation between plasma NT-proBNP levels and maternal complications. METHODS Research subject Tirty women with ≥20 weeks of gestation who visited, referred or underwent labor at Dr. Kariadi Hospital with severe preeclampsia based on 2016 PNPK