Microalbuminuria in pregnancy as a predictor of preeclampsia and eclampsia

Hypertensive disorders of pregnancy are common major complications of pregnancy and are responsible for significant morbidity and mortality in the fetus, the newborn infant and the mother.

To access if a single estimation of urinary microalbumin at booking would be of value in the prediction of subsequent development of preeclampsia or eclampsia

We studied at booking urinary microalbumin excretion in one hundred healthy normotensive Nigerian pregnant women attending the antenatal clinic and followed them till delivery. The women were grouped into 3 i.e. those with normal, micro and macro albumin excretion during analysis.

Ninety-three of these patients delivered at UCII, 2 had spontaneous abortions and five delivered elsewhere. At booking, 57 patients (61.3%) had normal albumin excretion and 22 (23.7%) and 14(15%) had microalbuminuria and gross albuminuria respectively. The men urinary albumin excretions for the normal, micro and gross albuminuria groups were 10.2 +/- 8.4, 67.0 +/- 55.2 and 321.4 +/- 14.0 mg/24 hours respectively. There was increased incidence of preeclampsia with an increase in albumin excretion and this was statistically significant (P value < 0.05). No patient developed eclampsia. With single urinary microalbumin excretion estimation at booking, the sensitivity, specificity, positive and negative predictive values of albuminuria were 88.9%, 67.9%, 22.2% and 98.3% respectively.

Urinary microalbumin excretion when used as a single test at booking appeared to predict preeclampsia with a high sensitivity but a low positive predictive value.