Clinical significance of uric acid, blood pressure anticipating proteinuria worsening in pregnant women of advanced age

Abstract

Background

Women of advanced maternal age are considered a high-risk obstetric population. Increases in serum uric acid levels, body mass index, and blood pressure have been associated with a higher likelihood of developing proteinuria. However, data on the predictive value of these factors for proteinuria progression specifically in this population remain limited.

Objectives

To determine the optimal cutoff values of serum uric acid, body mass index, systolic blood pressure, and diastolic blood pressure in predicting the progression of proteinuria in pregnant women of advanced maternal age.

Materials and methods

This was a cross-sectional descriptive study with longitudinal follow-up conducted among pregnant women who attended the Obstetrics Department of Vinh Long General Hospital from November 2022 to October 2023. Advanced maternal age was defined as maternal age of 35 years or older. Proteinuria was considered elevated when the 24-h urinary protein level reached ≥300 mg after the 20th week of gestation.

Results

A total of 100 pregnant women were enrolled, with a mean age of 38.6 ± 4.7 years. The proportions of active smoking and alcohol consumption were 18.0 % and 20.0 %, respectively. Overweight and obesity (OR = 6.06; 95 % CI: 1.97–18.59), smoking (OR = 3.89; 95 % CI: 1.30–11.59), and alcohol use (OR = 3.14; 95 % CI: 1.08–9.11) were significantly associated with the development of proteinuria. A pre-pregnancy body mass index (BMI) cut-off of 22.5 kg/m² showed the highest predictive value for proteinuria progression, with an area under the ROC curve (AUC) of 0.89 (95 % CI: 0.81–0.98), sensitivity of 86.2 %, and specificity of 92.3 %. Serum uric acid (AUC = 0.88), systolic blood pressure (AUC = 0.81), and diastolic blood pressure (AUC = 0.80) also demonstrated strong predictive performance.

Conclusion

Overweight/obesity, smoking, and alcohol consumption were identified as risk factors for increased proteinuria. In addition, pre-pregnancy BMI, serum uric acid levels, systolic blood pressure, and diastolic blood pressure all demonstrated strong predictive value for proteinuria progression in pregnant women of advanced maternal age.