Impact of random urine proteinuria on maternal and fetal outcomes of pregnancy: a retrospective case-control study
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background/Aims: Proteinuria is associated with hypertension and preeclampsia in pregnancy. However, the impact of random urine proteinuria on fetal and maternal outcomes has not been established. We investigated the influence of random urine proteinuria on the clinical outcomes of pregnancy. Methods: From January 2008 to December 2010, 2,822 patients were retrospectively studied. A total of 536 pregnant women with proteinuria in random urine and matched controls without proteinuria via propensity score matching were analyzed. Proteinuria was checked by the dipstick method. Results: The patients’ mean age was 33.0 ± 4.7 years, and the mean gestational age was 235.6 ± 50.6 days on admission. The prevalence of hypertension and chronic kidney disease was 2.4% (n = 67) and 1.0% (n = 29), respectively. Women with random urine proteinuria showed higher blood urea nitrogen levels and a higher incidence of hematuria. These women also had a higher incidence of preeclampsia, preterm labor, premature rupture of membranes, and intrauterine growth restriction. Proteinuria was strongly correlated with preeclampsia in both propensity score matching (p < 0.001, r = 0.783) and unmatched whole samples (p < 0.001, r = 0.851). Conclusions: These findings suggest that random urine proteinuria is associated with preeclampsia, preterm labor, premature rupture of membrane, and intrauterine growth restriction.
Abstract
Background/Aims: Proteinuria is associated with hypertension and preeclampsia in pregnancy. However, the impact of random urine proteinuria on fetal and maternal outcomes has not been established. We investigated the influence of random urine proteinuria on the clinical outcomes of pregnancy. Methods: From January 2008 to December 2010, 2,822 patients were retrospectively studied. A total of 536 pregnant women with proteinuria in random urine and matched controls without proteinuria via propensity score matching were analyzed. Proteinuria was checked by the dipstick method. Results: The patients’ mean age was 33.0 ± 4.7 years, and the mean gestational age was 235.6 ± 50.6 days on admission. The prevalence of hypertension and chronic kidney disease was 2.4% (n = 67) and 1.0% (n = 29), respectively. Women with random urine proteinuria showed higher blood urea nitrogen levels and a higher incidence of hematuria. These women also had a higher incidence of preeclampsia, preterm labor, premature rupture of membranes, and intrauterine growth restriction. Proteinuria was strongly correlated with preeclampsia in both propensity score matching (p < 0.001, r = 0.783) and unmatched whole samples (p < 0.001, r = 0.851). Conclusions: These findings suggest that random urine proteinuria is associated with preeclampsia, preterm labor, premature rupture of membrane, and intrauterine growth restriction.
참고문헌 (26)
- Martins-Costa SH, "Protein creatinine ratio in random urine sample of hypertensive pregnant women: maternal and perinatal outcomes", Hypertens Pregnancy, 30, pp.331~337 (2011)
- Wikstrom AK, "Random albumin", creatinine ratio for quantification of proteinuria in manifest pre-eclampsia, 2006, pp.113, 930~934
- Lambers Heerspink HJ, "Albuminuria assessed from first-morning-void urine samples versus 24-hour urine collections as a predictor of cardiovascular morbidity and mortality", Am J Epidemiol, 168, pp.897~905 (2008)
- Khazardoost S, "Comparison of 8-h urine protein and random urinary protein-to-creatinine ratio with 24-h urine protein in pregnancy", J Matern Fetal Neonatal Med, 25, pp.138~140 (2012)
- Robert M, "Random protein-creatinine ratio for the quantitation of proteinuria in pregnancy", Obstet Gynecol, 90, pp.893~895 (1997)
- Yamasmit W, "Correlation between random urinary protein-to-creatinine ratio and quantitation of 24-hour proteinuria in preeclampsia", J Med Assoc Thai, 86, pp.69~73 (2003)
- Sibai BM., "Treatment of hypertension in pregnant women", N Engl J Med, 335, pp.257~265 (1996)
- "Chapter 1: definition and classification of CKD", Kidney Int Suppl, 3, pp.19~62 (2011)
- National Kidney Foundation., "K", DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification, 2002, pp.39(2Suppl 1), S1~S266
- Qiu S., "Clinical analysis of the outcome of pregnancy with chronic renal disease", Zhonghua Fu Chan Ke Za Zhi, 28, pp.595~598 (1993)
- Haas DM, "Comparing ambulatory spot urine protein", creatinine ratios and 24-h urine protein measurements in normal pregnancies, 2003, pp.14, 233~236
- Saudan PJ, "Improved methods of assessing proteinuria in hypertensive pregnancy", Br J Obstet Gynaecol, 104, pp.1159~1164 (1997)
- Bell SC, "The role of observer error in antenatal dipstick proteinuria analysis", Br J Obstet Gynaecol, 106, pp.1177~1180 (1999)
- Rizk DE, "Predicting proteinuria in hypertensive pregnancies with urinary protein-creatinine or calcium-creatinine ratio", J Perinatol, 27, pp.272~277 (2007)
- Somanathan N, "A comparison between 24-hour and 2-hour urine collection for the determination of proteinuria", J Obstet Gynaecol, 23, pp.378~380 (2003)
- Amirabi A, "A comparison of 4- and 24-hour urine samples for the diagnosis of proteinuria in pregnancy", Iran J Med Sci, 36, pp.167~171 (2011)
- 박정화, "Random urine protein", creatinine ratio readily predicts proteinuria in preeclampsia, 2013, pp.56(01), 8~14[DOI]
- Boler L, "Quantitation of proteinuria in pregnancy by the use of single voided urine samples", Obstet Gynecol, 70, pp.99~100 (1987)
- Aggarwal N, "A prospective comparison of random urine protein-creatinine ratio vs 24-hour urine protein in women with preeclampsia", Medscape J Med, 10, pp.98~ (2008)
- Baba Y, "Urinary protein-to-creatinine ratio in pregnant women after dipstick testing: prospective observational study", BMC Pregnancy Childbirth, 15, pp.331~ (2015)
- James DK, "High Risk Pregnancy:Management Options", pp.2006, Saunders
- Gabbe SG, "Obstetrics: Normal and Problem Pregnancies", pp.2007, Churchill Livingstone
- ACOG Committee on Practice Bulletins: Obstetrics., "Diagnosis and management of preeclampsia and eclampsia. Number 33, January 2002", Obstet Gynecol, 99, pp.159~167 (2002)
- Papanna R, "Protein", creatinine ratio in preeclampsia: a systematic review, 2008, pp.112, 135~144
- Evans W, "Two-hour urine collection for evaluating renal function correlates with 24-hour urine collection in pregnant patients", J Matern Fetal Med, 9, pp.233~237 (2000)
- Adelberg AM, "Correlation of quantitative protein measurements in 8-, 12-, and 24-hour urine samples for the diagnosis of preeclampsia", Am J Obstet Gynecol, 185, pp.804~807 (2001)
