|Title||Massive Urinary Protein Excretion Associated with Greater Neonatal Risk in Preeclampsia.|
|Publication Type||Journal Article|
|Year of Publication||2017|
|Authors||Mateus, J, Newman, R, Sibai, B, Li, Q, Barton, J, C Combs, A, Guzman, E, Boggess, KA, Gyamfi, C, von Dadelszen, P, Woelkers, D|
|Date Published||2017 Jan|
The objective of this study was to compare clinical outcomes of preeclamptic pregnancies according to the proteinuria level. Secondary analysis of a multicenter prospective cohort study of women with preeclampsia (PE) symptomatology. Nonproteinuria, mild-proteinuria, and massive-proteinuria PEs were defined as: < 165 mg in 12 hours or < 300 mg in 24 hours, 165 mg to 2.69 g in 12 hours or 300 mg to 4.99 g in 24 hours, and ≥ 2.7 g in 12 hours or ≥ 5.0 g in 24 hours, respectively. Individual and composite maternal, fetal, and neonatal outcomes were compared among the PE groups. Of the 406 analyzed pregnancies, 36 (8.8%) had massive-proteinuria PE, 268 (66.0%) mild-proteinuria PE, and 102 (25.1%) nonproteinuria PE. Compared with the other groups, massive-proteinuria PE women had significantly higher blood pressures ( < 0.001), epigastric pain ( = 0.007), and uric acid serum levels ( < 0.001) prior to delivery. Composite maternal morbidity was similar across the groups. Delivery < 34 weeks occurred in 80.6, 49.3, and 22.5% of massive-proteinuria, mild-proteinuria, and nonproteinuria PE groups, respectively ( < 0.0001). Composite adverse neonatal outcomes were significantly higher in the massive-proteinuria PE compared with the other groups ( = 0.001). While potentially not important diagnostically, massive proteinuria is associated with more severe clinical manifestations of PE prompting earlier delivery.
|Alternate Journal||AJP Rep|
|PubMed Central ID||PMC5365400|