Does microalbuminuria at mid-pregnancy predict development of subsequent pre-eclampsia?

Area of Science:

• Obstetrics and Gynecology
• Nephrology
• Perinatal Medicine

Background:

• Pre-eclampsia is a leading cause of maternal and neonatal morbidity.
• Early identification of risk factors for pre-eclampsia is crucial for timely intervention.
• Microalbuminuria has been investigated as a potential biomarker for various conditions.

Purpose of the Study:

• To evaluate the utility of mid-pregnancy microalbuminuria, assessed by albumin-to-creatinine ratio (ACR), as a predictor of pre-eclampsia.
• To explore the association between microalbuminuria and secondary outcomes such as preterm birth and neonatal birthweight.

Main Methods:

• A prospective observational study involving 144 normotensive pregnant women (aged <35, BMI <25kg/m²) between 24-28 weeks gestation.
• Urine samples were analyzed for albumin-to-creatinine ratio (ACR); microalbuminuria defined as ACR 30-299 mg/g.
• Participants were followed until delivery to record the incidence of pre-eclampsia, preterm birth, and neonatal birthweight.

Main Results:

• Microalbuminuria was detected in 22.9% (33/144) of women.
• Microalbuminuric women had significantly higher mean blood pressure and ACR compared to normotensive counterparts.
• Among microalbuminuric women, 36.4% developed pre-eclampsia, 24.2% had preterm births, and mean birthweight was significantly lower (2.45±0.6 kg).

Conclusions:

• Mid-pregnancy microalbuminuria is a significant predictor of subsequent pre-eclampsia development.
• Microalbuminuria is also associated with an increased risk of preterm birth and low-birthweight neonates.
• ACR measurement in mid-pregnancy offers a valuable tool for identifying high-risk pregnancies.