Aynaoğlu Yıldız Gülşah, Topdağı Yılmaz Emsal Pınar
Department of Obstetrics and Gynecology, Ankara University Faculty of Medicine, Ankara, Turkey.
Department of Obstetrics and Gynecology, Atatürk University Faculty of Medicine, Erzurum, Turkey.
J Turk Ger Gynecol Assoc. 2022 Sep 5;23(3):190-198. doi: 10.4274/jtgga.galenos.2022.2022-4-3.
Hypertensive diseases of pregnancy are one of the leading causes of maternal and perinatal mortality worldwide. The aim of this study was to evaluate the association between protein levels in 24-hour urine samples and maternal and perinatal outcomes in preeclamptic patients.
This retrospective cohort study was conducted with pregnant women who were diagnosed with preeclampsia (PE) and delivered in our clinic between 2010 and 2018. Patients were divided into those with a proteinuria value below 300 mg/24 h (non-proteinuria), proteinuria value between 300-2000 mg/24 h (mild proteinuria), proteinuria value between 2000-5000 mg/24 h (severe proteinuria) and proteinuria value >5000 mg/24 h (massive proteinuria) and were compared in terms of maternal and perinatal outcomes. Demographic characteristics (age, body mass index in kg/m2, gravidity), PE-related clinical symptoms (epigastric pain, neurological and respiratory symptoms), laboratory findings (24 h protein level, lactate dehydrogenase, aspartate aminotransferase, platelet count and creatine levels) were recorded in all patients.
A total of 1,379 patients meeting the study criteria were included. There were 315 (23%) patients in the non-proteinuria group, 704 (51%) in the mild proteinuria group, 234 (17%) patients in the severe group and 126 (9%) patients in the massive proteinuria group. The massive proteinuria group was found to have the highest rates of maternal and prenatal complications. The Apgar score, umbilical cord pH value, birth weight, gestational week at delivery, intrauterine growth restriction and intrauterine fetal death were significantly higher in the massive proteinuria group.
Our data showed that the degree of proteinuria appears to be associated with maternal, fetal and neonatal outcomes among women diagnosed with PE. Women with proteinuria of >5000 mg/24 hours had notably poorer natal outcomes.
妊娠期高血压疾病是全球孕产妇和围产儿死亡的主要原因之一。本研究的目的是评估子痫前期患者24小时尿样中蛋白质水平与孕产妇和围产儿结局之间的关联。
本回顾性队列研究针对2010年至2018年间在我院诊断为子痫前期（PE）并分娩的孕妇进行。患者被分为蛋白尿值低于300mg/24h（无蛋白尿）、蛋白尿值在300 - 2000mg/24h（轻度蛋白尿）、蛋白尿值在2000 - 5000mg/24h（重度蛋白尿）和蛋白尿值>5000mg/24h（大量蛋白尿）的组，并在孕产妇和围产儿结局方面进行比较。记录所有患者的人口统计学特征（年龄、体重指数（kg/m²）、妊娠次数）、与PE相关的临床症状（上腹部疼痛、神经和呼吸症状）、实验室检查结果（24小时蛋白质水平、乳酸脱氢酶、天冬氨酸转氨酶、血小板计数和肌酐水平）。
共有1379名符合研究标准的患者被纳入。无蛋白尿组有315名（23%）患者，轻度蛋白尿组有704名（5l%）患者，重度组有234名（17%）患者，大量蛋白尿组有126名（9%）患者。发现大量蛋白尿组的孕产妇和产前并发症发生率最高。大量蛋白尿组的阿氏评分、脐带血pH值、出生体重、分娩孕周、宫内生长受限和宫内胎儿死亡情况明显更差。
我们的数据表明，蛋白尿程度似乎与诊断为PE的女性的孕产妇、胎儿和新生儿结局相关。24小时蛋白尿>5000mg的女性的分娩结局明显更差。
