Microalbuminuria in pregnancy as a predictor of preeclampsia and eclampsia.

INTRODUCTION: Hypertensive disorders of pregnancy are common major complications of pregnancy and are responsible for significant morbidity and mortality in the fetus, the newborn infant and the mother.
OBJECTIVES: To access if a single estimation of urinary microalbumin at booking would be of value in the prediction of subsequent development of preeclampsia or eclampsia
METHODS: We studied at booking urinary microalbumin excretion in one hundred healthy normotensive Nigerian pregnant women attending the antenatal clinic and followed them till delivery. The women were grouped into 3 i.e. those with normal, micro and macro albumin excretion during analysis.
RESULTS: Ninety-three of these patients delivered at UCII, 2 had spontaneous abortions and five delivered elsewhere. At booking, 57 patients (61.3%) had normal albumin excretion and 22 (23.7%) and 14(15%) had microalbuminuria and gross albuminuria respectively. The men urinary albumin excretions for the normal, micro and gross albuminuria groups were 10.2 +/- 8.4, 67.0 +/- 55.2 and 321.4 +/- 14.0 mg/24 hours respectively. There was increased incidence of preeclampsia with an increase in albumin excretion and this was statistically significant (P value < 0.05). No patient developed eclampsia. With single urinary microalbumin excretion estimation at booking, the sensitivity, specificity, positive and negative predictive values of albuminuria were 88.9%, 67.9%, 22.2% and 98.3% respectively.
CONCLUSION: Urinary microalbumin excretion when used as a single test at booking appeared to predict preeclampsia with a high sensitivity but a low positive predictive value.