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The impact of proteinuria on maternal and perinatal outcomes among women with pre‐eclampsia
Author(s) -
Guida Jose P.,
Parpinelli Mary A.,
Surita Fernanda G.,
Costa Maria L.
Publication year - 2018
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12487
Subject(s) - medicine , proteinuria , eclampsia , pregnancy , obstetrics , incidence (geometry) , retrospective cohort study , kidney , physics , biology , optics , genetics
Objective To assess the impact of proteinuria on pregnancy outcomes among women with pre‐eclampsia. Methods The present retrospective cohort study included patients with pre‐eclampsia who delivered at a referral maternity hospital in Brazil between January 1, 2009, and December 31, 2013. Patients were stratified into three groups based on 24‐hour urinary protein excretion during pregnancy: mild (0.3–<2.0 g), severe (2.0–<5.0 g), and massive (≥5.0 g). Results There were 293 patients included in the study; 88, 129, and 76 had mild, severe, and massive proteinuria, respectively. Chronic hypertension was the most frequent pre‐existing condition among all women (86 [29.4%]). The mean pregnancy duration at the onset of maternal pre‐eclampsia was longest in the mild group compared and decreased with increasing proteinuria severity ( P <0.001). Preterm delivery was recorded among 205 of 293 (70.0%) neonates; there were 66 (22.5%) neonates that were preterm and in the massive proteinuria group. The incidence of severe pre‐eclampsia was lowest in the mild proteinuria group ( P =0.002) and tended to occur at 34 weeks. Cesarean delivery rates exceeded 80.0% in all groups. Most patients assessed at 40–60 days postpartum remained proteinuric (40/61[66%]). Conclusions Quantifying the severity of proteinuria could identify a subgroup of women with pre‐eclampsia at increased risk of adverse outcomes.