Association of proteinuria threshold in pre-eclampsia with maternal and perinatal outcomes: a nested case control cohort of high risk women.
OBJECTIVES:To evaluate occurrence of adverse maternal and perinatal outcomes with different thresholds of proteinuria (300-499 mg and ≥500 mg/24 hours) in pre-eclamptic women, comparing outcomes against women with chronic and gestational hypertension. DESIGN:Secondary analysis of the Vitamins in Pre...
Main Authors: | , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Public Library of Science (PLoS)
2013-01-01
|
Series: | PLoS ONE |
Online Access: | http://europepmc.org/articles/PMC3794944?pdf=render |
id |
doaj-1e2a930c1f43467a89e87f72f30d3a7a |
---|---|
record_format |
Article |
spelling |
doaj-1e2a930c1f43467a89e87f72f30d3a7a2020-11-25T00:04:23ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-01810e7608310.1371/journal.pone.0076083Association of proteinuria threshold in pre-eclampsia with maternal and perinatal outcomes: a nested case control cohort of high risk women.Kate BramhamCarlos E Poli-de-FigueiredoPaul T SeedAnnette L BrileyLucilla PostonAndrew H ShennanLucy C ChappellOBJECTIVES:To evaluate occurrence of adverse maternal and perinatal outcomes with different thresholds of proteinuria (300-499 mg and ≥500 mg/24 hours) in pre-eclamptic women, comparing outcomes against women with chronic and gestational hypertension. DESIGN:Secondary analysis of the Vitamins in Pre-Eclampsia Trial. SETTING:25 UK hospitals in ten geographical areas. POPULATION:946 women with pre-existing risk factors for pre-eclampsia. METHODS:Women with pre-eclampsia and proteinuria 300-499 mg/24 h (PE300, referent group, n=60) or proteinuria ≥500 mg/24 h (PE500, n=161) were compared with two groups of non-proteinuric women with chronic hypertension (CHT, n=615) or gestational hypertension (GH, n=110). MAIN OUTCOME MEASURES:MATERNAL: progression to severe hypertension. Perinatal: small for gestational age (SGA) <5(th) centile, gestation at delivery. RESULTS:Severe hypertension occurred more frequently in PE500 (35%) and PE300 (27%) than CHT (5.9%; P≤0.01) and GH (10%; p≤0.001). Gestation at delivery was earlier in PE500 (33.2 w) than PE300 (37.3 w; P≤0.001), and later in CHT (38.3 w; P≤0.05) and GH (39.1 w; P≤0.001). SGA infants were more frequent in PE300 (32%) than in CHT (13.3%; P≤0.001) and GH (16.5%; P≤0.05). Women in PE500 were more likely to have a caesarean section than PE300 (78% vs. 48%; P≤0.001), and to receive magnesium sulphate (17% vs. 1.7%, P≤0.05). CONCLUSION:Women with PE300 have complication rates above those of women managed as out-patients (GH and CHT), meriting closer surveillance and confirming 300 mg/d as an appropriate threshold for determining in-patient management. Adverse perinatal outcomes are higher still in women with PE500.http://europepmc.org/articles/PMC3794944?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Kate Bramham Carlos E Poli-de-Figueiredo Paul T Seed Annette L Briley Lucilla Poston Andrew H Shennan Lucy C Chappell |
spellingShingle |
Kate Bramham Carlos E Poli-de-Figueiredo Paul T Seed Annette L Briley Lucilla Poston Andrew H Shennan Lucy C Chappell Association of proteinuria threshold in pre-eclampsia with maternal and perinatal outcomes: a nested case control cohort of high risk women. PLoS ONE |
author_facet |
Kate Bramham Carlos E Poli-de-Figueiredo Paul T Seed Annette L Briley Lucilla Poston Andrew H Shennan Lucy C Chappell |
author_sort |
Kate Bramham |
title |
Association of proteinuria threshold in pre-eclampsia with maternal and perinatal outcomes: a nested case control cohort of high risk women. |
title_short |
Association of proteinuria threshold in pre-eclampsia with maternal and perinatal outcomes: a nested case control cohort of high risk women. |
title_full |
Association of proteinuria threshold in pre-eclampsia with maternal and perinatal outcomes: a nested case control cohort of high risk women. |
title_fullStr |
Association of proteinuria threshold in pre-eclampsia with maternal and perinatal outcomes: a nested case control cohort of high risk women. |
title_full_unstemmed |
Association of proteinuria threshold in pre-eclampsia with maternal and perinatal outcomes: a nested case control cohort of high risk women. |
title_sort |
association of proteinuria threshold in pre-eclampsia with maternal and perinatal outcomes: a nested case control cohort of high risk women. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2013-01-01 |
description |
OBJECTIVES:To evaluate occurrence of adverse maternal and perinatal outcomes with different thresholds of proteinuria (300-499 mg and ≥500 mg/24 hours) in pre-eclamptic women, comparing outcomes against women with chronic and gestational hypertension. DESIGN:Secondary analysis of the Vitamins in Pre-Eclampsia Trial. SETTING:25 UK hospitals in ten geographical areas. POPULATION:946 women with pre-existing risk factors for pre-eclampsia. METHODS:Women with pre-eclampsia and proteinuria 300-499 mg/24 h (PE300, referent group, n=60) or proteinuria ≥500 mg/24 h (PE500, n=161) were compared with two groups of non-proteinuric women with chronic hypertension (CHT, n=615) or gestational hypertension (GH, n=110). MAIN OUTCOME MEASURES:MATERNAL: progression to severe hypertension. Perinatal: small for gestational age (SGA) <5(th) centile, gestation at delivery. RESULTS:Severe hypertension occurred more frequently in PE500 (35%) and PE300 (27%) than CHT (5.9%; P≤0.01) and GH (10%; p≤0.001). Gestation at delivery was earlier in PE500 (33.2 w) than PE300 (37.3 w; P≤0.001), and later in CHT (38.3 w; P≤0.05) and GH (39.1 w; P≤0.001). SGA infants were more frequent in PE300 (32%) than in CHT (13.3%; P≤0.001) and GH (16.5%; P≤0.05). Women in PE500 were more likely to have a caesarean section than PE300 (78% vs. 48%; P≤0.001), and to receive magnesium sulphate (17% vs. 1.7%, P≤0.05). CONCLUSION:Women with PE300 have complication rates above those of women managed as out-patients (GH and CHT), meriting closer surveillance and confirming 300 mg/d as an appropriate threshold for determining in-patient management. Adverse perinatal outcomes are higher still in women with PE500. |
url |
http://europepmc.org/articles/PMC3794944?pdf=render |
work_keys_str_mv |
AT katebramham associationofproteinuriathresholdinpreeclampsiawithmaternalandperinataloutcomesanestedcasecontrolcohortofhighriskwomen AT carlosepolidefigueiredo associationofproteinuriathresholdinpreeclampsiawithmaternalandperinataloutcomesanestedcasecontrolcohortofhighriskwomen AT paultseed associationofproteinuriathresholdinpreeclampsiawithmaternalandperinataloutcomesanestedcasecontrolcohortofhighriskwomen AT annettelbriley associationofproteinuriathresholdinpreeclampsiawithmaternalandperinataloutcomesanestedcasecontrolcohortofhighriskwomen AT lucillaposton associationofproteinuriathresholdinpreeclampsiawithmaternalandperinataloutcomesanestedcasecontrolcohortofhighriskwomen AT andrewhshennan associationofproteinuriathresholdinpreeclampsiawithmaternalandperinataloutcomesanestedcasecontrolcohortofhighriskwomen AT lucycchappell associationofproteinuriathresholdinpreeclampsiawithmaternalandperinataloutcomesanestedcasecontrolcohortofhighriskwomen |
_version_ |
1725429730258190336 |