Massive Urinary Protein Excretion Associated with Greater Neonatal Risk in Preeclampsia

TY - JOUR

T1 - Massive Urinary Protein Excretion Associated with Greater Neonatal Risk in Preeclampsia

AU - Mateus, Julio

AU - Newman, Roger

AU - Sibai, Baha M.

AU - Li, Qing

AU - Barton, John R.

AU - Combs, C. Andrew

AU - Guzman, Edwin

AU - Boggess, Kim A.

AU - Gyamfi, Cynthia

AU - von Dadelszen, Peter

AU - Woelkers, Doug

PY - 2017

Y1 - 2017

N2 - Objective The objective of this study was to compare clinical outcomes of preeclamptic pregnancies according to the proteinuria level. Study Design 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. Results Of the 406 analyzed pregnancies, 36 (8.8%) hadmassive-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 higherbloodpressures (p < 0.001), epigastric pain (p ¼ 0.007), and uric acid serum levels (p < 0.001) prior to delivery. Compositematernal morbidity was similar across the groups. Delivery < 340/7 weeks occurred in 80.6, 49.3, and 22.5% of massive-proteinuria, mild-proteinuria, and nonproteinuria PE groups, respectively (p < 0.0001). Compositeadverse neonatal outcomes were significantly higher in themassiveproteinuria PE compared with the other groups (p ¼ 0.001). Conclusion While potentially not important diagnostically, massive proteinuria is associated with more severe clinical manifestations of PE prompting earlier delivery.

AB - Objective The objective of this study was to compare clinical outcomes of preeclamptic pregnancies according to the proteinuria level. Study Design 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. Results Of the 406 analyzed pregnancies, 36 (8.8%) hadmassive-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 higherbloodpressures (p < 0.001), epigastric pain (p ¼ 0.007), and uric acid serum levels (p < 0.001) prior to delivery. Compositematernal morbidity was similar across the groups. Delivery < 340/7 weeks occurred in 80.6, 49.3, and 22.5% of massive-proteinuria, mild-proteinuria, and nonproteinuria PE groups, respectively (p < 0.0001). Compositeadverse neonatal outcomes were significantly higher in themassiveproteinuria PE compared with the other groups (p ¼ 0.001). Conclusion While potentially not important diagnostically, massive proteinuria is associated with more severe clinical manifestations of PE prompting earlier delivery.

U2 - 10.1055/s-0037-1601866

DO - 10.1055/s-0037-1601866

M3 - Article

SN - 2157-6998

VL - 07

SP - e49-e58

JO - American Journal of Perinatology Reports

JF - American Journal of Perinatology Reports

IS - 01

ER -