Proteinuria is associated with worse outcomes in babies born to mothers with preeclampsia: A retrospective cohort study at a tertiary referral hospital in Brazil.
Ana Clara Ferreira, Samara Mirelly Dos Santos Guedes, Tamara Cristina Gomes Ferraz Rodrigues, Priscila Oliveira Barbosa, Ricardo de Carvalho Cavalli
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引用次数: 0
Abstract
To evaluate whether the presence of proteinuria, although no longer mandatory in the revised diagnostic criteria, results in worse maternal and fetal outcomes in preeclampsia (PE). A retrospective cohort study was conducted, analyzing data from pregnant patients diagnosed with PE between January 2015 and December 2019 at a tertiary care center in Brazil. Ethical approval was obtained, and the patient records were reviewed to assess maternal and perinatal outcomes based on the revised diagnostic criteria by the College of Obstetricians and Gynecologists, focusing on the presence or absence of proteinuria. The study included 816 pregnant patients with PE, of whom 685 (83.9%) were diagnosed based on proteinuria. The revised criteria, which include indicators of organ damage, identified an additional 131 cases (16.4%). Analysis showed no significant differences in maternal outcomes between proteinuria and non-proteinuria groups, including intensive care unit (ICU) admission, acute pulmonary edema (APE), HELLP syndrome, eclampsia, or C-section rates. However, babies born to mothers with proteinuria PE experienced worse outcomes, including fetal growth restriction, low birth weight, ICU admission, and higher rates of preterm birth. Relative risk analysis demonstrated a high risk of babies being born with low birth weight, ICU admission, and being born preterm and very preterm in cases where proteinuria was present in mothers with PE. The presence of proteinuria is associated with significantly worse outcomes in babies born to mothers with preeclampsia, while no significant differences were observed in maternal outcomes.
目的是评估虽然在修订后的诊断标准中蛋白尿不再是强制性的,但蛋白尿的存在是否会导致子痫前期(PE)的母体和胎儿预后更差。我们开展了一项回顾性队列研究,分析了2015年1月至2019年12月期间在巴西一家三级医疗中心确诊为子痫前期的孕妇数据。该研究获得了伦理批准,并根据妇产科医师学会修订后的诊断标准审查了患者的病历,以评估孕产妇和围产期的结局,重点是有无蛋白尿。研究纳入了 816 名患有 PE 的孕妇,其中 685 人(83.9%)是根据蛋白尿确诊的。修订后的标准包括器官损伤指标,又发现了 131 例(16.4%)。分析表明,蛋白尿组和非蛋白尿组的产妇结局无明显差异,包括重症监护室(ICU)入院率、急性肺水肿(APE)、HELLP 综合征、子痫或剖腹产率。然而,患有蛋白尿 PE 的母亲所生的婴儿的预后较差,包括胎儿生长受限、出生体重低、入住重症监护室和早产率较高。相对风险分析表明,在患有 PE 的母亲出现蛋白尿的情况下,婴儿出生时体重过轻、入住重症监护室、早产和极早产的风险很高。患有子痫前期的母亲如果出现蛋白尿,婴儿的预后会明显变差,而产妇的预后则无明显差异。
期刊介绍:
The International Journal of Gynecology & Obstetrics publishes articles on all aspects of basic and clinical research in the fields of obstetrics and gynecology and related subjects, with emphasis on matters of worldwide interest.