Diagnostic utility of protein excretion in 24-hour urine and the protein to creatinine ratio for adverse perinatal outcomes and time of delivery

24 saatlik idrarda protein atılımının tanılayıcı kullanımı ve advers perinatal sonuçlar ile doğum zamanı için protein-kreatinin oranı

Didem Dereli AKDENİZ, İbrahim ÖMEROĞLU, Hakan GÖLBAŞI, Atalay EKİN, Ceren GÖLBAŞI

Abstract

Objective: Our study aimed to evaluate the perinatal and neonatal outcomes of hypertensive pregnant women with or without protein- uria. We compared the predictivity of spot urinary protein to crea- tinine (P/C) ratio and 24-hour protein excretions on outcomes. Methods: We retrospectively enrolled 230 pregnant women with a new diagnosis of hypertension between 20 and 37 weeks of gesta- tion. We divided the patients into two groups according to the pro- tein level determined by 24-hour urine collection and P/C ratio. The presence and level of proteinuria, its relationship with the P/C ratio, and the relationship between these findings and perinatal out- comes were evaluated. Results: Gestational age at delivery weeks and latency period (dura- tion between diagnosis of hypertension and delivery) were signifi- cantly earlier in pregnant women with ≥300 mg/24-h and P/C ratio ≥0.3. Adverse neonatal outcomes were significant in patients with proteinuria ≥300 mg/24-hour and P/C ratio ≥0.3. Urinary protein levels in 24-hour urine were significantly higher in pregnant women with P/C ratio ≥0.3 and a significantly positive correlation was found between 24-h proteinuria and P/C (r=0.382, p

Özet

Amaç: Çal›flmam›zda, proteinürisi olan veya olmayan hipertansif gebelerde perinatal ve neonatal sonuçlar› de¤erlendirmeyi amaçla- d›k. Spot üriner protein ile kreatinin oran›n›n (P/C) ve 24-saatlik protein at›l›m›n›n sonuçlar üzerindeki prediktivitesini karfl›laflt›r- d›k. Yöntem: Gebeli¤in 20. ve 37. haftalar› aras›nda yeni hipertansiyon tan›s› alm›fl 230 gebe retrospektif olarak çal›flmaya dahil edildi. Al›- nan 24 saatlik idrar ve P/C ile belirlenen protein seviyesine göre hastalar iki gruba ayr›ld›. Proteinüri varl›¤› ve seviyesi, P/C oran›y- la olan iliflkisi ve bu bulgular ile perinatal sonuçlar aras›ndaki iliflki de¤erlendirildi. Bulgular: Do¤um esnas›ndaki gestasyonel yafl ve gecikme dönemi (hipertansiyon tan›s› ile do¤um aras›ndaki süre), ≥300 mg/24 saat ve P/C ≥0.3 de¤erlerine sahip gebelerde anlaml› flekilde daha er- kendi. Advers neonatal sonuçlar, proteinürisi ≥300 mg/24 saat ve P/C≥0.3 olan hastalarda anlaml›yd›. 24 saatlik idrarda üriner pro- tein seviyeleri, P/C ≥0.3 de¤erine sahip gebelerde anlaml› flekilde daha yüksekti ve 24 saatlik proteinüri ile P/C aras›nda anlaml› fle- kilde pozitif bir korelasyon bulundu (r=0.382, p