Microalbuminuria is a predictor of adverse pregnancy outcomes including preeclampsia |
| |
| Affiliation: | 1. Westmead Hospital, Sydney, NSW, Australia;2. Sydney Medical School, University of Sydney, Australia;1. University of Vermont, Department of Obstetrics, Gynecology and Reproductive Sciences, Burlington, VT 05405, United States;2. University of Vermont, Department of Medical Biostatistics, Burlington, VT 05405, United States;3. University of Vermont, Department of Pediatrics, Burlington, VT 05405, United States;4. Vermont Oxford Network, Burlington, VT 05401, United States;1. Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, The Netherlands;2. Department of Obstetrics and Gynecology, Beatrixziekenhuis, Gorinchem, The Netherlands;3. Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands;4. Department of Nephrology, Academic Medical Center, Amsterdam, The Netherlands;5. Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands;6. The Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Australia;1. Institute for Medical Biochemistry, Department for Biomedical Sciences, University of Veterinary Medicine Vienna, Veterinaerplatz 1, A-1210 Vienna, Austria;2. Environmental Research and Innovation (ERIN) Department, Luxembourg Institute of Science and Technology (LIST), 5, avenue des Hauts-Fourneaux, L-4362 Esch-sur-Alzette, Grand-duchy of Luxembourg;3. Wageningen University, Human and Animal Physiology, P.O. Box 338, 6700 AH Wageningen, The Netherlands;4. Charité-Universitätsmedizin Berlin, Institute for Experimental Endocrinology, Augustenburger Platz 1, 13353, Berlin, Germany;5. Wageningen University, Division of Toxicology, Tuinlaan 5, 6703HE Wageningen, The Netherlands;6. Wageningen Institute for Marine Resources & Ecosystem Studies, IMARES, IJmuiden, The Netherlands;1. Division of Maternal Fetal Medicine, Rutgers New Jersey Medical School, Newark, NJ, United States;2. Department of Obstetrics, Gynecology, and Women’s Health, Atlantic Health System, Morristown, NJ, United States;3. Department of Maternal Fetal Medicine, Atlantic Health System, Morristown, NJ, United States;4. Department of Cardiology, Atlantic Health System, Morristown, NJ, United States;1. Department of Medicine, Faculty of Science, University of Mauritius, Réduit, Mauritius;2. Sylus Pharmaceuticals Ltd, Centre for Innovation and Enterprise, University of Oxford, Begbroke Science Park, Sandy Lane, Yarnton OX5 1PF, United Kingdom;3. Research Department of Immunology, Division of Infection and Immunity, University College London Medical School, Windeyer Building, 46 Cleveland Street, London W1P 6DB, United Kingdom;1. Department of Obstetrics & Gynecology, Affiliated Hospital, Logistical College of Chinese People’s Armed Police Forces, Tianjin 300162, PR China;2. Maternity & Children Hospital of Northwest District, Shaanxi, Xi’an 710003, PR China;3. Department of Obstetrics & Gynecology, Xijing Hospital, Fourth Military Medical University, Shaanxi, Xi’an 710033, PR China |
| |
| Abstract: | ![]()
ObjectivesAbnormal urinary protein loss is a marker associated with a diverse range of renal diseases including preeclampsia. Current measures of urine protein used in the diagnostic criteria for the diagnosis of preeclampsia includes urine protein:creatinine ratio and 24-h urine protein. However very little is known about the value of urine albumin:creatinine ratio (uACR) in pregnancy. In this study we examined the prognostic value of microalbuminuria detected antepartum to predict adverse pregnancy outcomes.DesignThis is a single-centre retrospective analysis of 84 pregnant women over the age of 16 attending a tertiary ‘high-risk’ pregnancy outpatient clinic between July 2010 and June 2013. Utilising medical records, antepartum peak uACR level and pregnancy maternal and fetal outcomes were recorded.FindingsThe primary outcome was a composite of poor maternal and fetal outcomes including preeclampsia, maternal death, eclampsia, stillbirth, neonatal death, IUGR, premature delivery and placental abruption. As the antepartum peak uACR level (in mg/mmol) increased from normoalbuminuria (uACR < 3.5) to microalbuminuria (uACR 3.5–35) to macroalbuminuria (>35), the percentage of women with the primary composite outcome increased in a stepwise fashion (13.8% to 24.1% to 62.1% respectively, p < 0.001). After adjusting for covariates including history of hypertension, chronic kidney disease and aspirin therapy during pregnancy, micro- and macroalbuminuria remained significant predictors of the primary outcome.ConclusionsWe have shown that antepartum peak uACR is a useful simple marker to help predict adverse maternal and fetal outcomes. Further studies are required to utilise uACR as a prognostic tool in pregnancy before it can be applied in clinical practice. |
| |
| Keywords: | Albumin:creatinine ratio Preeclampsia Proteinuria Microalbuminuria Pregnancy |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
