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Association of ST2 Elevation in the Early Third Trimester with Heart Failure and Pre-Eclampsia in the Peripartum Period

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Author(s)
Hyungseop KimIn-Cheol KimJin-Gon BaeHee-Jeong LeeJung-Ho ParkJin-Eun Song
Keimyung Author(s)
Kim, Hyung SeopKim, In CheolBae, Jin Gon
Department
Dept. of Internal Medicine (내과학)
Dept. of Obstetrics & Gynecology (산부인과학)
Journal Title
J Womens Health (Larchmt)
Issued Date
2022
Volume
31
Issue
11
Keyword
ST2heart failurepre-eclampsiapregnancyperipartum
Abstract
Background:
Although high-risk pregnancies are common in clinical practice, there are limited data on the association of soluble suppression of tumorigenicity 2 (ST2) with pregnancy-related complications. The rates of maternal complications, including heart failure (HF) during the peripartum period, were evaluated according to the ST2 level.

Methods:
A single-center retrospective cohort study included and stratified 259 women with high-risk pregnancies in their early third trimester according to the ST2 levels. The primary endpoint was the occurrence of peripartum HF based on symptoms, N-terminal pro-brain natriuretic peptide, or echocardiography associated with fluid retention. The secondary endpoints consisted of pre-eclampsia, silent pleural effusion, and pericardial effusion during the peripartum period. We performed a logistic model for the association between ST2 and maternal complications.

Results:
Of the 259 patients (mean age: 36.4 years, mean gestational duration: 31.6 weeks), advanced age ≥35 years and twin gestation were the most prevalent risk factors. Patients with ST2 ≥ 35 ng/mL showed enlarged cardiac chambers. Peripartum HF occurred in 2 (1.6%) out of 121 patients with ST2 < 35 ng/mL and in 47 (34%) out of 138 patients with ST2 ≥ 35 ng/mL. Those with ST2 ≥ 35 ng/mL were more likely to have the secondary endpoints (40.6% vs. 5.8%, p < 0.001). After adjustment, ST2 ≥ 35 ng/mL was associated with a six-fold occurrence of peripartum HF and a four-fold increase in the secondary endpoints.

Conclusions:
In women with high-risk pregnancies, peripartum HF and pre-eclampsia were not uncommon, and ST2 ≥ 35 ng/mL in the third trimester was independently related to maternal complications.
Keimyung Author(s)(Kor)
김형섭
김인철
배진곤
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
1931-843X
Source
https://www.liebertpub.com/doi/10.1089/jwh.2021.0403
DOI
10.1089/jwh.2021.0403
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44724
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
1. School of Medicine (의과대학) > Dept. of Obstetrics & Gynecology (산부인과학)
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