Department of Obstetrics and Gynecology, Aichi Medical University School of Medicine, Aichi, Japan.
Department of Obstetrics and Gynecology, Aichi Medical University School of Medicine, Aichi, Japan.
Pregnancy Hypertens. 2022 Aug;29:30-35. doi: 10.1016/j.preghy.2022.05.009. Epub 2022 May 28.
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.
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.
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.
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.
本研究旨在验证子痫前期妇女的严重程度分类是否因蛋白尿超过 2.0 g/24 h 而不同。
本回顾性队列研究收集了 2008 年 4 月 1 日至 2021 年 9 月 30 日期间在爱知医科大学医院就诊的单胎妊娠合并子痫前期和蛋白尿的女性患者的数据。根据蛋白尿是否超过 2.0 g/24 h，将参与者分为两组（高蛋白尿组和低蛋白尿组）。在两组之间，使用美国妇产科医师学会（ACOG）严重程度分类（严重特征）评估母亲的严重程度，并比较围产期和新生儿结局。
与蛋白尿较低的子痫前期妇女相比，蛋白尿较高的妇女更早分娩且更早被诊断为子痫前期。后者组还表现出更高的胸腔积液或腹水、早产和早期早产发生率，以及更低的出生体重和出生体重标准差。此外，高蛋白尿组新生儿入住新生儿重症监护病房（NICU）的比例也较高。与低蛋白尿组相比，高蛋白尿组中被归类为“严重”的妇女比例更高。与低蛋白尿组相比，高蛋白尿组中患有严重高血压和新发头痛的妇女比例更高。区分严重和非严重母亲病例的最佳蛋白尿截断值被确定为 2.2 g/24 h。
蛋白尿超过 2.0 g/24 h 的子痫前期妇女中更常见严重程度分类，特别是严重高血压和新发头痛的比例更高。
