Determining the relationship between severity of proteinuria and adverse maternal and neonatal outcomes in patients with preeclampsia
Year: 2024
Type: article
Study design: Observational Study
Abstract: • Women with preeclampsia and a higher urine protein-creatinine ratio have a higher risk of developing HELLP syndrome. • We found no correlation between the amount of proteinuria and neonatal outcomes in women with preeclampsia. • Although a rare outcome, the development of pulmonary oedema strongly correlated with larger amount of proteinuria. • Higher urine protein-creatinine ratio was associated with the development of severely elevated blood pressure (>160/110 mmHg). • Increased amount of proteinuria did not correlate with the need for more than one agent to control blood pressure. To investigate the relationship between the severity of proteinuria and adverse maternal and neonatal outcomes in patients with preeclampsia (PE). Prospective cohort study conducted in Gauteng, South Africa over 12 months. Patients with PE 18 years or older with singleton pregnancies were recruited. We included 248 in the final analysis. Proteinuria was quantified using urine protein: creatinine ratio (UPCR). Preeclamptic patients’ outcomes were compared according to the UPCR values using regression models and by generating receiver operator characteristic (ROC) curves. Primary maternal outcomes were gestational age (GA) at diagnosis, GA at delivery, development of eclampsia, development of severe features and the need for more than one antihypertensive agent. Neonatal outcomes were admission to neonatal unit, 5-min APGAR score, need for ventilatory support and early neonatal death. There was a weak but significant negative correlation between GA at delivery and UPCR (Spearman’s correlation coefficient (SCC) −0.191, p = 0.002). Most patients (77 %) required >1 agent to control their blood pressure, however there was no correlation between UPCR and the need for additional agents (SCC −0.014, p = 0.828). There was a statistically significant correlation between UPCR and severe features, especially the development of haemolysis, elevated liver enzymes and low platelet (HELLP) syndrome (p = 0.005). There was no significant correlation between neonatal outcomes and UPCR. Severity of proteinuria correlated with earlier delivery and development of severe features, specifically HELLP syndrome and pulmonary oedema. There was no correlation between UPCR and requiring additional antihypertensive agents or neonatal outcomes.
Source: Pregnancy Hypertension
Institutions: Kalafong Hospital, University of Pretoria
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,000
OpenAlex ID: W4402302683