Amount of proteinuria as associated with severity classification of pregnant women with preeclampsia

Tomohito Okamoto; Kazushi Watanabe; Taiki Banno; Takuya Saitou; Kazumasa Sugiura; Ai Iwasaki; Hiroshi Matsushita; Akihiko Wakatsuki

doi:10.1016/j.preghy.2022.05.009

Amount of proteinuria as associated with severity classification of pregnant women with preeclampsia

Pregnancy Hypertens. 2022 Aug:29:30-35. doi: 10.1016/j.preghy.2022.05.009. Epub 2022 May 28.

Authors

Tomohito Okamoto¹, Kazushi Watanabe², Taiki Banno³, Takuya Saitou¹, Kazumasa Sugiura¹, Ai Iwasaki¹, Hiroshi Matsushita¹, Akihiko Wakatsuki¹

Affiliations

¹ Department of Obstetrics and Gynecology, Aichi Medical University School of Medicine, Aichi, Japan.
² Department of Obstetrics and Gynecology, Aichi Medical University School of Medicine, Aichi, Japan. Electronic address: kw446433@aichi-med-u.ac.jp.
³ Medical student, Aichi Medical University School of Medicine, Aichi, Japan.

PMID: 35687971
DOI: 10.1016/j.preghy.2022.05.009

Abstract

Objective: This study aimed to verify whether the severity classification of preeclamptic women differed by the presence or absence of proteinuria exceeding 2.0 g/24 h.

Methods: In this retrospective cohort study, data were collected from women with singleton pregnancies who presented with preeclampsia and proteinuria at Aichi Medical University Hospital between April 1, 2008 and September 30, 2021. Participants were divided into two groups (high proteinuria and low proteinuria) based on whether or not their proteinuria exceeded 2.0 g/24 h. Between the two groups, severity of maternal was assessed using the American College of Obstetricians and Gynecologists (ACOG) severity classification (Severe Features) and perinatal and neonatal outcomes were compared.

Results: Relative to preeclamptic women with lower proteinuria group, those with higher proteinuria group delivered and were diagnosed with preeclampsia at an earlier gestational week. The latter group also exhibited higher rates of pleural effusion or ascites, preterm birth, and early preterm birth, in addition to lower birth weight and birth weight SD. Rates of admission to the NICU were also higher for neonates born to preeclamptic women in the higher proteinuria group. The percentage of women classified as 'severe' was higher in the higher proteinuria group relative to that in the lower proteinuria group. The percentage of those with severe hypertension and new-onset headache was higher in the higher proteinuria group compared to the lower proteinuria group. The optimal proteinuria cutoff value that distinguished between severe and non-severe maternal cases was determined to be 2.2 g/24 h.

Conclusions: Severity classifications were more common among preeclamptic women with proteinuria exceeding 2.0 g/24 h, particularly with regard to the percentage of those with severe hypertension and new-onset headache.

Keywords: Perinatal and neonatal outcome; Preeclampsia; Proteinuria; Severity.

MeSH terms

Birth Weight
Female
Headache / complications
Humans
Hypertension* / complications
Infant, Newborn
Pre-Eclampsia* / diagnosis
Pregnancy
Pregnant Women
Premature Birth*
Proteinuria / diagnosis
Retrospective Studies