Proteinuric and Non-proteinuric Pre-eclampsia: A Comparative Analysis of Risk Factor Profile, Clinical Picture,...

Pre-eclampsia, a hypertensive disorder of pregnancy remains a challenge worldwide despite advance in the medical science and research due to its adverse impact on pregnancy.

To compare the clinical characteristics, sociodemographic risk factors and the pregnancy outcomes between proteinuric and non-proteinuric pre-eclampsia incorporating the revised definition.

A prospective observational study consisting of 147 case of pre-eclampsia as per ISSHP-2018 diagnostic criteria of which 91 (63.6%) with proteinuria and 52 (36.4%) were without proteinuria. The maternal characteristics and pregnancy outcome were studied in both the groups and analyzed using appropriate statistical method.

Use of revised definition lead to 1.5% increase in the incidence of pre-eclampsia (PE). A significantly higher proportion of non-proteinuric PE were ≤ 30 years as compared to proteinuric PE (78.8% vs. 61.5%, p value: 0.033). The proteinuric PE had significantly higher mean systolic and mean arterial pressure (p value: 0.011), higher association with clinically severe disease (p value: 0.008), higher values of serum creatinine (p value: 0.024) and serum LDH levels (p value: 0.004), higher rate of growth retarded fetus (p value: 0.029), low birth weight (p value: 0.014) and peri-natal mortality (p value: 0.018) as compared to non-proteinuric PE. However, the binary logistic regression analysis failed to demonstrate any significant difference between the two groups in any of the maternal characteristics or pregnancy outcome measures.

PE with or without proteinuria can be equally severe compromising the pregnancy outcome and hence demands for increase supervision and monitoring once diagnosis of PE is established.