Prognostic and Predictive Roles of Proteinuria and Adverse Pregnancy Outcomes

Abstract

Background and Aims: Occurrence of a transient proteinuria during pregnancy could be considered a physiological process but a huge amount of persistent proteinuria lead to glomerular and tubule-interstitial damage which lead to end-stage renal disease, thus poor pregnancy outcomes for both mothers and fetus. In the present study we aimed to detect the predictive roles and the association between presence of proteinuria, amount of proteinuria and adverse pregnancy outcomes for early detection and improving mother and infant outcomes.Patients and methods; this is a retrospective cohort study which included 300 females suffering from proteinuria during pregnancy in. We divided patients into 3 categories according to proteinuria levels: mild proteinuria, moderate proteinuria and severe proteinuria. We compared between the groups regarding maternal and fetal outcomes.Results: There is statistically significant relation between grade of proteinuria and all of need for CS (P<0.001), incidence of severe PE (P<0.001), HELLP syndrome (P<0.001), and hypoalbuminemia (P=0.002), prematurity (P<0.001), neonatal asphyxia (P=0.009), low birth weight (P<0.001), need for NICU admission(p<0.001), fetal distress (P=0.023) and overall incidence of adverse perinatal outcome (P<0.001). The cutoff of 24-hour urine protein in prediction of poor perinatal outcome is ≥972.5 with area under curve 0.796, sensitivity 99.2%, specifically 51.1% (P<0.001).Conclusions: Those levels of proteinuria during pregnancy are considered an important predictive factor for adverse neonatal and maternal outcomes, particularly moderate and severe proteinuria.