Abstract
Background The WHO recommends blood pressure (BP) and proteinuria measurement at each antenatal care (ANC) visit, but the value of proteinuria testing in normotensive women has been questioned, especially where dehydration is common. Objective We sought to determine prevalence and prognosis of baseline proteinuria in CLIP (Community Level Intervention in Pre-eclampsia, cluster randomised trials, NCT01911494). Methods In CLIP intervention clusters, women received enhanced antenatal care by trained community health care providers supported by the Piers-On-the-Move (POM) app. Each assessment included BP measurement (validated CRADLE device). The first and all hypertensive visits included proteinuria dipstick testing (visual). Progression to hypertension and adverse outcomes (not available in Nigeria) were compared by baseline proteinuria (chi-squared, p Results In 27 intervention clusters, 20,804 (64.3%) women received ⩾ 1 POM visit and delivered by trial end (India, 6102; Pakistan, 10,932; Mozambique, 4310; Nigeria, 6999). Baseline proteinuria ⩾ 1+ (assessed in >90%) was Discussion With low prevalence of baseline proteinuria and lack of strong relationships with outcomes, these data question current WHO recommendations to routinely assess proteinuria in pregnancy.
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