Kim Mi Jung, Kim Young Nam, Jung Eun Jung, Jang Hye Ree, Byun Jung Mi, Jeong Dae Hoon, Sung Moon Su, Lee Kyung Bok, Kim Ki Tae
Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
Paik Institute for Clinical Research, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
Obstet Gynecol Sci. 2017 May;60(3):260-265. doi: 10.5468/ogs.2017.60.3.260. Epub 2017 May 15.
The aim of this study was to investigate whether massive proteinuria in preeclampsia is associated with maternal and fetal complications.
We retrospectively analyzed the clinical records of 233 patients who were diagnosed with preeclampsia. We divided the preeclamptic patients into three groups based on the amount of proteinuria: massive (≥5 g/24 hr), moderate (2 to 5 g/24 hr) and mild (<2 g/24 hr) proteinuria group. We analyzed the clinical characteristics and maternal and neonatal complications among three groups.
Gestational age at diagnosis and delivery were lower in women with massive and moderate proteinuria group than women with mild proteinuria group (31.5±3.1 vs. 32.3±3.6 vs. 34.0±3.5 weeks, <0.001 for gestational weeks at diagnosis; 34.6±3.6 vs. 35.1±4.1 vs. 36.9±4.0 weeks, =0.001 for gestational age at delivery). In maternal complications, the incidences of pleural effusion and retinal detachment were significantly different among three groups (29.9% vs. 22.4% vs. 9.0%, =0.004 for pleural effusion; 11.5% vs. 3.0% vs. 1.3%, =0.009 for retinal detachment). Creatinine levels were higher and albumin levels were lower in the massive proteinuria group than in the moderate and mild groups. However, other maternal and neonatal complications were not significantly different among three groups.
Massive proteinuria might be associated with renal albumin excretion-related morbidity, such as pleural effusion, retinal detachment, and low serum albumin levels. Furthermore, it was associated with early-onset preeclampsia and early delivery.
本研究旨在调查子痫前期大量蛋白尿是否与母婴并发症相关。
我们回顾性分析了233例被诊断为子痫前期患者的临床记录。我们根据蛋白尿的量将子痫前期患者分为三组:大量蛋白尿组(≥5 g/24小时)、中度蛋白尿组(2至5 g/24小时)和轻度蛋白尿组(<2 g/24小时)。我们分析了三组患者的临床特征以及母婴并发症情况。
大量蛋白尿组和中度蛋白尿组患者诊断时和分娩时的孕周低于轻度蛋白尿组(诊断时孕周:31.5±3.1周 vs. 32.3±3.6周 vs. 34.0±3.5周,诊断时孕周<0.001;分娩时孕周:34.6±3.6周 vs. 35.1±4.1周 vs. 36.9±4.0周,分娩时孕周=0.001)。在母体并发症方面,三组患者胸腔积液和视网膜脱离的发生率有显著差异(胸腔积液:29.9% vs. 22.4% vs. 9.0%,胸腔积液=0.004;视网膜脱离:11.5% vs. 3.0% vs. 1.3%,视网膜脱离=0.009)。大量蛋白尿组的肌酐水平高于中度和轻度蛋白尿组,白蛋白水平低于中度和轻度蛋白尿组。然而,其他母婴并发症在三组之间无显著差异。
大量蛋白尿可能与肾白蛋白排泄相关的发病率有关,如胸腔积液、视网膜脱离和低血清白蛋白水平。此外,它还与早发型子痫前期和早产有关。