Wai Hang Chung1, William Wing Kee To2. 1. Department of Obstetrics and Gynecology, United Christian Hospital, Kwun Tong, Hong Kong. Electronic address: cwh194@ha.org.hk. 2. Department of Obstetrics and Gynecology, United Christian Hospital, Kwun Tong, Hong Kong. Electronic address: towkw@ha.org.hk.
Abstract
OBJECTIVE: To examine maternal and neonatal outcomes of gestational proteinuria, and to identify maternal characteristics for progression to pre-eclampsia. STUDY DESIGN: Retrospective cohort. Included all pregnant women who delivered between Jan 2014-Feb 2017 with new onset proteinuria in a single obstetric unit. Demographic, maternal and neonatal outcomes were compared. RESULTS: Eighteen (25%) out of 73 women with new onset gestational proteinuria developed pre-eclampsia. The incidence of gestational proteinuria was 0.54%. Compared with women that remained normotensive, those that developed hypertension had delivery at earlier gestation (p = .02), increased risk of fetal growth restriction (p = .01) and lower newborn birthweight (p = .002). Maximal proteinuria and fetal growth restriction were independent factors associated with development of pre-eclampsia. In particular, high proteinuria level ≥ 2 g/d constitute a major predictor for progression (p = .03). CONCLUSION: Increased vigilance for antenatal surveillance is important in women with gestational proteinuria as a substantial portion progress to pre-eclampsia. Serial growth scan and proteinuria assay are suggested to predict possible pre-eclampsia development.
OBJECTIVE: To examine maternal and neonatal outcomes of gestational proteinuria, and to identify maternal characteristics for progression to pre-eclampsia. STUDY DESIGN: Retrospective cohort. Included all pregnant women who delivered between Jan 2014-Feb 2017 with new onset proteinuria in a single obstetric unit. Demographic, maternal and neonatal outcomes were compared. RESULTS: Eighteen (25%) out of 73 women with new onset gestational proteinuria developed pre-eclampsia. The incidence of gestational proteinuria was 0.54%. Compared with women that remained normotensive, those that developed hypertension had delivery at earlier gestation (p = .02), increased risk of fetal growth restriction (p = .01) and lower newborn birthweight (p = .002). Maximal proteinuria and fetal growth restriction were independent factors associated with development of pre-eclampsia. In particular, high proteinuria level ≥ 2 g/d constitute a major predictor for progression (p = .03). CONCLUSION: Increased vigilance for antenatal surveillance is important in women with gestational proteinuria as a substantial portion progress to pre-eclampsia. Serial growth scan and proteinuria assay are suggested to predict possible pre-eclampsia development.
Authors: Laura A Magee; Sumedha Sharma; Esperança Sevene; Rahat N Qureshi; Ashalata Mallapur; Salésio E Macuácua; Shivaprasad Goudar; Mrutunjaya B Bellad; Olalekan O Adetoro; Beth A Payne; John Sotunsa; Anifa Valá; Jeffrey Bone; Andrew H Shennan; Marianne Vidler; Zulfiqar A Bhutta; Peter von Dadelszen Journal: Bull World Health Organ Date: 2020-09-09 Impact factor: 9.408