Abstract
BackgroundProteinuria is one of the common manifestations of patients with preeclampsia (PE), but whether the severity of proteinuria is related to the pregnancy outcome of patients with preeclampsia remains controversial. The present study aimed to determine the relationship between 24-h proteinuria and adverse outcomes in patients with preeclampsia.MethodsThe present retrospective study included 329 pregnant women in Chongqing, China. Patients were divided into PE group and non-PE group. PE group was stratified into three subgroups based on the level of 24-h proteinuria. Correlation analysis was used to analyze the correlation between biochemical indexes and adverse pregnancy outcome, and Logistic regression analysis was used to analyze the risk factors of adverse pregnancy outcome. The receiver operating characteristic curve (ROC) was used to evaluate the ability of 24-h urinary protein to distinguish the adverse pregnancy outcome in patients with preeclampsia.Results(1) Between PE and non-PE group, cesarean section rate in PE group was significantly higher than that in non-PE group (84.4% vs. 25.9%, p < 0.001). Laboratory findings such as uric acid and creatinine level in PE group were higher than those in non-PE group. (2) Among mild (proteinuria < 0.3 g/24 h), moderate (0.3 g/24 h ≦ proteinuria < 2 g/24 h) and massive (proteinuria ≧ 2 g/24 h) groups, the frequencies of induced labor (p = 0.006) and stillbirth (p = 0.002) increased with the increase of 24-h proteinuria. (3) Adverse outcomes were positively correlated with 24-h proteinuria (adverse maternal outcomes: r = 0.239, p = 0.002; adverse fetal outcomes: r = 0.336, p < 0.001). (4) The best 24-h proteinuria cutoff values to determine stillbirth, premature and fetal distress were 3965.0 mg/24 h, 984.75 mg/24 h and 1503.85 mg/24 h and their odds ratio (95% confidence interval) were 12.46 (3.46–44.88), 2.48 (1.15–5.37) and 10.02 (2.14–46.80), respectively.ConclusionsThe severity of 24-h proteinuia may forecast adverse outcomes in women with preeclampsia. We suggest proteinuria should be retained as one of the monitoring indexes in patients with preeclampsia.Trial registrationRetrospectively registered. (LTMCMTS202001).
Highlights
Proteinuria is one of the common manifestations of patients with preeclampsia (PE), but whether the severity of proteinuria is related to the pregnancy outcome of patients with preeclampsia remains controversial
We suggest proteinuria should be retained as one of the monitoring indexes in patients with preeclampsia
Contrary to Newman’s [19], Sérgio Hofmeister Martins-Costa’s [20] findings, their studies showed that excessive proteinuria did not mean a more serious outcome, and the increased proteinuria had nothing to do with the risk of adverse outcomes, but in present study, we found the increase of proteinuria could add the rate of adverse outcome of preeclampsia
Summary
Proteinuria is one of the common manifestations of patients with preeclampsia (PE), but whether the severity of proteinuria is related to the pregnancy outcome of patients with preeclampsia remains controversial. The present study aimed to determine the relationship between 24-h proteinuria and adverse outcomes in patients with preeclampsia. A number of studies have shown that patients with preeclampsia should be wary of the occurrence of adverse pregnancy outcomes when massive proteinuria occurs [1, 3, 5]. Many studies have suggested that the degree of proteinuria has nothing to do with the severity of preeclampsia, and there is no definite relationship between proteinuria and pregnancy outcome in patients with preeclampsia [9, 10]. We retrospectively analyzed the relationship between 24-h proteinuria and adverse pregnancy outcome in patients with preeclampsia, and explored whether the degree of proteinuria affected the adverse pregnancy outcome in order to provide evidence for clinical diagnosis and treatment of preeclampsia
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