Predictive value of 24-hour urine protein levels for adverse maternal and perinatal outcomes in hypertensive pregnancies.

IF 2.1 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Hypertension in Pregnancy Pub Date : 2025-12-01 Epub Date: 2025-06-30 DOI:10.1080/10641955.2025.2524327

Şebnem Karagün, Hamza Yıldız, Yusuf Dal, Sefanur Gamze Karaca, Ahmet Zeki Nessar, Mürşide Çevikoğlu Kıllı, Ayhan Coşkun

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引用次数: 0

Abstract

Background: Proteinuria is a widely used biomarker for risk stratification in hypertensive pregnancies, with potential predictive value for adverse maternal and perinatal outcomes. This study evaluated the predictive value of 24-hour urine protein levels for adverse maternal and perinatal outcomes in hypertensive pregnancies.

Methods: A retrospective cohort of 213 pregnant women with hypertension was categorized into four groups based on proteinuria severity: <300 mg (n = 147), 300-500 mg (n = 22), 500-2000 mg (n = 25), and > 2000 mg (n = 19).

Methods: Higher proteinuria levels were significantly associated with increased rates of oligohydramnios (p = 0.001) and fetal growth restriction (FGR; p = 0.005), particularly in the > 2000 mg group (44.0% and 68.4%, respectively). Gestational age at delivery decreased with worsening proteinuria (p < 0.001), with the lowest mean age (32.84 ± 3.82 weeks) in the > 2000 mg group. Postpartum hospital stays were prolonged in chronic hypertension (p = 0.002) and severe proteinuria groups (p = 0.007). ROC analysis identified a 24-hour urine protein cutoff of 135 mg (AUC: 0.635, p = 0.001) for predicting fetal distress. The > 2000 mg group had universal magnesium sulfate use, earlier deliveries, and higher FGR rates. Chronic hypertension correlated with longer postpartum stays (p = 0.002) and higher postpartum renal disease (p = 0.040).

Conclusion: These findings underscore proteinuria as a prognostic marker for adverse outcomes, supporting its role in risk stratification for hypertensive pregnancies. Future research should validate thresholds and explore targeted interventions.

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24小时尿蛋白水平对高血压妊娠孕产妇和围产期不良结局的预测价值。

背景：蛋白尿是一种广泛用于高血压妊娠风险分层的生物标志物，对孕产妇和围产期不良结局具有潜在的预测价值。本研究评估了24小时尿蛋白水平对高血压妊娠孕妇和围产期不良结局的预测价值。方法：213例高血压孕妇按蛋白尿严重程度分为4组：n = 147、300-500 mg （n = 22）、500-2000 mg （n = 25）和bb0 -2000 mg （n = 19）。方法：较高的蛋白尿水平与羊水过少发生率增加（p = 0.001）和胎儿生长受限(FGR；P = 0.005)，尤其是> 2000 mg组（分别为44.0%和68.4%）。分娩时胎龄随蛋白尿加重而降低（p 2000 mg组）。慢性高血压组（p = 0.002）和重度蛋白尿组（p = 0.007）产后住院时间延长。ROC分析发现，24小时尿蛋白临界值为135 mg （AUC: 0.635, p = 0.001）可用于预测胎儿窘迫。> 2000 mg组普遍使用硫酸镁，分娩提前，FGR率较高。慢性高血压与产后住院时间较长（p = 0.002）和产后肾病发生率较高（p = 0.040）相关。结论：这些发现强调了蛋白尿作为不良结局的预后标志物，支持其在高血压妊娠风险分层中的作用。未来的研究应该验证阈值并探索有针对性的干预措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hypertension in Pregnancy 医学-妇产科学

CiteScore

3.40

自引率

0.00%

发文量

审稿时长

6 months

期刊介绍： Hypertension in Pregnancy is a refereed journal in the English language which publishes data pertaining to human and animal hypertension during gestation. Contributions concerning physiology of circulatory control, pathophysiology, methodology, therapy or any other material relevant to the relationship between elevated blood pressure and pregnancy are acceptable. Published material includes original articles, clinical trials, solicited and unsolicited reviews, editorials, letters, and other material deemed pertinent by the editors.