Spot urine protein measurements in normotensive pregnancies, pregnancies with isolated proteinuria and preeclampsia

Andrea Kattah, Natasa Milic, Wendy White, Vesna D Garovic

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

We performed a prospective, longitudinal study of pregnant women presenting to their first obstetrics visits to characterize the changes in spot urine protein-to-creatinine (UPCR) and albumin-to-creatinine ratios (UACR) in normotensive pregnancies, as well as identify clinical characteristics associated with isolated proteinuria and preeclampsia. We measured spot urinary albumin, protein, and creatinine at the first prenatal visit, end of the second trimester, and at delivery. In the normotensive pregnancies (n = 142), we found that from the beginning of pregnancy to delivery, UACR increased by a median [interquartile range (IQR)] of 14.7 mg/g Cr (3.74-51.8) and UPCR by 60 mg/g Cr (30-130) (P < 0.001 for both changes). Isolated proteinuria (defined as UPCR > 300 mg/g Cr in the absence of hypertension) was identified in 19/142 (13.4%) normotensive pregnancies. Increases in systolic and diastolic blood pressure from early pregnancy to delivery and increases in UACR from early to midpregnancy were associated with isolated proteinuria at delivery. Twelve women developed preeclampsia. Nulliparity, early, and midpregnancy diastolic blood pressures were strongly associated with the development of preeclampsia, but early changes in UACR were not. In conclusion, women who develop isolated proteinuria at delivery have a larger increase in blood pressure than women without proteinuria and have a “microalbuminuric” phase earlier in gestation, unlike women who develop preeclampsia. These findings suggest a different mechanism of urine protein excretion in women with isolated proteinuria as compared with women with preeclampsia, where proteinuria has a more abrupt onset.

Original languageEnglish (US)
Pages (from-to)R418-R424
JournalAmerican Journal of Physiology - Regulatory Integrative and Comparative Physiology
Volume313
Issue number4
DOIs
StatePublished - Oct 9 2017

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Pre-Eclampsia
Proteinuria
Creatinine
Urine
Pregnancy
Albumins
Blood Pressure
Proteins
Second Pregnancy Trimester
Parity
Obstetrics
Longitudinal Studies
Pregnant Women
Prospective Studies
Hypertension

Keywords

  • Albuminuria
  • Preeclampsia
  • Pregnancy
  • Proteinuria

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)

Cite this

Spot urine protein measurements in normotensive pregnancies, pregnancies with isolated proteinuria and preeclampsia. / Kattah, Andrea; Milic, Natasa; White, Wendy; Garovic, Vesna D.

In: American Journal of Physiology - Regulatory Integrative and Comparative Physiology, Vol. 313, No. 4, 09.10.2017, p. R418-R424.

Research output: Contribution to journalArticle

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