Preeclampsia is associated with increased NT-proBNP and altered lipid profiles in umbilical cord blood: a propensity score-matched analysis

Abstract

Objectives: Preeclampsia (PE) is a hypertensive disorder of pregnancy related to adverse maternal and neonatal outcomes. While its effects on maternal health are well established, its impact on neonatal cardiovascular health remains incompletely understood. The aim of this study was to analyze metabolic and cardiovascular biomarkers in umbilical cord blood from pregnancies affected by PE. Methods: A single-center retrospective observational study was conducted at Gyeongsang National University Changwon Hospital from September 2023 to December 2024. Umbilical cord blood samples from neonates of mothers with PE (n=72) and normotensive pregnancies (n=456) were analyzed to identify the lipid profiles and measure the levels of cardiovascular biomarkers. Propensity score matching (PSM) was applied to control for confounding variables such as maternal BMI and gestational age. Results: After PSM, neonates born to mothers with PE had significantly higher total umbilical cord blood cholesterol levels (80.12 +/- 32.45 vs. 67.27 +/- 20.00 mg/dL, p<0.001), lower HDL cholesterol levels (29.12 +/- 7.36 vs. 31.24 +/- 6.75 mg/dL, p=0.042), and elevated NT-proBNP levels (3,805.43 +/- 8,412.21 vs. 1,516.50 +/- 2,439.78 pg/mL, p=0.004). Troponin-T levels were not significantly different between the groups after matching (p=0.320). Conclusions: PE significantly alters umbilical cord blood lipid profiles and cardiovascular biomarkers, suggesting negative implications for the cardiovascular health of the fetus and early metabolic programming. Elevated NT-proBNP levels may serve as an early marker of neonatal cardiac stress, whereas abnormal lipid profiles may necessitate long-term cardiovascular monitoring.