Risk factors triggering the development of preeclampsia in pregnant women with isolated gestational proteinuria and perinatal outcomes

Abstract

Aim: To determine the risk factors for preeclampsia in isolated gestational proteinuria and to compare perinatal outcomes between women who did and did not develop preeclampsia. Methods: Seventy-six pregnants, who were diagnosed with isolated proteinuria between January 2016 and June 2017, were evaluated retrospectively. Data on sociodemographic characteristics, blood pressure and gestational age at onset of proteinuria, the amount of proteinuria, laboratory findings, gestational age at birth, birth weight, mode of delivery, Apgar scores, neonatal intensive care unit admission and perinatal mortality were recorded. Results: The incidence of isolated proteinuria was 0.44% (76/17,000). Preeclampsia developed in 18 (23.7%) patients. Systolic blood pressure at the onset of proteinuria was higher in patients with proteinuria and preeclampsia. There was no difference between the two groups in gestational age at birth, birth weight, delivery mode, neonatal intensive care unit admission, Apgar scores, postpartum hemorrhage, cerebrovascular event and maternal death. In logistic regression model, as age (OR=0.749, 95% CI=0.681-0.854, p=0.021) and gestational age at onset of proteinuria (OR=0.632, 95% CI=0.421-0.748, p=0.008) increased, the risk of preeclampsia decreased. Also, logistic regression model revealed that as systolic blood pressure at onset of proteinuria (OR=1.24, %95 CI=1.038-1.254, p=0.014) increased the risk of preeclampsia increased. Moreover, a systolic blood pressure of >122.3 mmHg at onset of proteinuria was found to be a predictor of preeclampsia with a sensitivity of 53.8% and specificity of 77.8%. Conclusion: Although favorable perinatal outcomes have been reported, isolated gestational proteinuria is associated with the risk of preeclampsia development. Particularly, in pregnant women with proteinuria detected in early pregnancy and high systolic blood pressure at onset of proteinuria, the risk of preeclampsia development increases. Therefore, patients should be monitored regularly. Considering the fact that we found similar perinatal outcomes between the two groups, we assume that close follow-up of pregnant women with isolated gestational proteinuria is necessary even in the absence of preeclampsia.