Association between proteinuria and maternal and neonatal outcomes in pre-eclampsia pregnancy: a retrospective observational study

Abstract

Objectives To evaluate the association between proteinuria and maternal and neonatal outcomes in pregnant women with pre-eclampsia. Methods This retrospective study included patients beyond 20 weeks of gestation diagnosed with pre-eclampsia, who were admitted to Suzhou Municipal Hospital between December 2013 and December 2015. Demographic and clinical data were extracted from clinical records, including age, body mass index, newborn weight and Apgar score. Pre-eclampsia risk factors and perinatal outcomes were analysed. Results A total of 407 patients were enrolled, of whom, 402 with pre-eclampsia were included in the final analyses, divided into two groups: patients with proteinuria ( n = 364 [90.55%]) and patients without proteinuria ( n = 38 [9.45%]). Newborn 5-min Apgar scores were statistically lower in the proteinuria group versus the group without proteinuria (9.77 versus 9.95). Compared with patients without proteinuria, patients with proteinuria had a significantly higher rate of births before 37 weeks of gestation (50.80% versus 31.60%), but the incidence of preterm membrane rupture was significantly lower (3.8% versus 13.2%). Conclusion Proteinuria may be associated with adverse maternal and neonatal outcomes in cases of pre-eclampsia.

Earlier onset of proteinuria or hypertension is a predictor of progression from gestational hypertension or gestational proteinuria to preeclampsia

“…Bouzari et al concluded that proteinuria in women with preeclampsia as diagnosed according to new criteria is associated with adverse outcomes of pregnancy, although it is not an adequate predictor 18 . However, in more recent studies, severe and massive proteinuria in women with preeclampsia as diagnosed according to new criteria were related to poor maternal and neonatal outcomes 19 – 21 .…”

A study of the correlation of spot urinary protein - creatinine ratio in antenatal patients with hypertensive disorders on severity of preeclampsia, maternal organ dysfunction and its implication on perinatal outcomes

“…The Perinatal Mortality was greater with proteinúria (175 vs 19, 7) and, when = 2.0g (297.8 vs 19.6).10 In our study, a significant association was seen in terms of livebirths when a cutoff of 0.3 for spot urinary proteincreatinine ratio was taken, however, there was no significant relationship when the perinatal outcome was studied in terms of NICU Admission, low birth weight babies, prematurity, APGAR < 7 at 5 minutes, and intrauterine fetal demise. Xu X et al (2020) [11] , evaluated 407 patients with preeclampsia and studied the association between proteinuria and maternal and neonatal outcomes in pregnant women with pre-eclampsia and found that the newborn 5-min Apgar scores were statistically lower in the proteinuria group versus the group without proteinuria (9.77 versus 9.95). Compared with patients without proteinuria, patients with proteinuria had a significantly higher rate of births before 37 weeks of gestation (50.80% versus 31.60%) [11] .…”

“…Xu X et al (2020) [11] , evaluated 407 patients with preeclampsia and studied the association between proteinuria and maternal and neonatal outcomes in pregnant women with pre-eclampsia and found that the newborn 5-min Apgar scores were statistically lower in the proteinuria group versus the group without proteinuria (9.77 versus 9.95). Compared with patients without proteinuria, patients with proteinuria had a significantly higher rate of births before 37 weeks of gestation (50.80% versus 31.60%) [11] . In our study, 5 minutes APGAR score of < 7 was observed in ~ 204 ~ 29.48% and 23.08% cases of severe preeclampsia with proteincreatine ratio ≥ 0.3 and < 0.3 respectively against 16.92% and 10.77% cases of mild preeclampsia with protein-creatine ratio ≥ 0.3 and < 0.3 respectively and prematurity was seen in 25.64% and 12.82% cases of severe preeclampsia with protein-creatine ratio ≥ 0.3 and < 0.3 respectively against 16.92% and 7.69% cases of mild preeclampsia with protein-creatine ratio ≥ 0.3 and < 0.3 respectively…”

A várandósság során jelentkező proteinuria differenciáldiagnosztikájának nehézségei

“…Vérnyomása romló tendenciát nem mutatott. A 28. várandóssági héten többszöri laboratóriumi kontroll során is jelentős proteinuria (15,(8)(9)(10)(11)(12)(13)(14)(15)(16)8 g/nap, szelektív glomerularis proteinuria, klinikai albuminuria), mérsékelten romló albuminszint (30-29 g/l) mutatkozott. A vizeletüledékben vörösvértest +, fehérvérsejt + mutatkozott, cylinder nem volt igazolható.…”

“…A várandósság alatt diagnosztizált kóros mértékű proteinuria etiológiájának tisztázásakor elsődleges a praeeclampsia kizárása [11], hiszen ez a terhesség során igazolt proteinuria leggyakoribb oka. Megkülönböztetünk átmeneti proteinuriát, melyet normális vesefunkció kísér, A proteinuria a hypertonia mellett a praeeclampsia egyik kardinális jele [12], mely a perinatalis anyai és magzati morbiditás, mortalitás vezető oka [13][14][15][16]. Fontos azonban hangsúlyoznunk, hogy a proteinuria praeeclampsiában hiányozhat.…”