Twenty-four-hour urinary protein excretion in uncomplicated singleton pregnancy - 05/01/24
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Abstract |
Background |
Twenty-four-hour urinary total protein excretion is an essential parameter used for evaluation of renal function and early detection of gestational complications. However, data on reference ranges of 24-hour urinary total protein excretion in normal pregnancy are scarce.
Objective |
This study aimed to determine reference ranges for 24-hour urinary total protein excretion in a population with uncomplicated singleton pregnancies using a standard method for urinary total protein. In addition, the values of 24-hour urinary total protein were stratified by maternal age and prepregnancy body mass index.
Study Design |
This study was based on a prospective cohort study in Shenzhen, China. The pregnant women were enrolled at their first prenatal clinical visit. All the participants were instructed to collect 24-hour urine samples during the following successive gestational periods: 6+0 to 13+6, 14+0 to 27+6, and 28+0 to 41+6 weeks. Total urinary protein excretion was analyzed by a colorimetric method. Ultimately, the study encompassed a total of 4844 pregnant women with uncomplicated pregnancies. The nonparametric percentile method was used to determine reference ranges for 24-hour urinary total protein excretion during different trimesters in women with uncomplicated pregnancies (excluding those with previous kidney disorders, gestational or chronic hypertension, preeclampsia, and pregestational diabetes mellitus, among others).
Results |
The 24-hour urinary total protein levels expressed as medians and percentiles (5th, 95th) for each trimester were as follows: 72.0 (28.4, 165.0), 88.0 (34.0, 185.0), and 108.0 (37.5, 258.0) mg in the first, second, and third trimesters, respectively. A significant increase in 24-hour urinary total protein excretion was observed throughout pregnancy (all P values <.001). Moreover, 24-hour urinary total protein levels were higher in the older (≥35 years) than in the younger (<35 years) group from mid-gestation. Specifically, the median (interquartile range) 24-hour urinary total protein levels by age were 72.2 (50.6–100.0) vs 70.5 (50.5–100.0) mg, 85.8 (62.0–117.0) vs 96.0 (68.0–127.8) mg, and 106.6 (76.0–146.2) vs 114.7 (81.5–153.6) mg in the first, second, and third trimesters, respectively. In addition, 24-hour proteinuria was significantly increased in higher-weight (overweight or obese) subgroups compared with lower-weight (underweight or normal-weight) subgroups (all P values <.05).
Conclusion |
Our study provides reference values for 24-hour urinary total protein excretion with apparently uncomplicated pregnancies. Understanding these changes in low-risk pregnancies is essential for optimizing maternal management.
Le texte complet de cet article est disponible en PDF.Video |
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Deng. Urinary total protein excretion in uncomplicated pregnancy. Am J Obstet Gynecol 2023.
Le texte complet de cet article est disponible en PDF.Key words : 24-hour urinary total protein excretion, reference ranges, uncomplicated pregnant women
Plan
The authors report no conflict of interest. |
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This work was supported by the Medical and Health Science and Technology Plan attached to Longgang District Science and Technology Development Special Funding (LGKCYLWS2021000025), the Districtal Key Technologies R&D Program of Longgang, Shenzhen, China (LGKCYLWS2022009), and the Guangdong Basic and Applied Basic Research Foundation (2023A1515010112). We are grateful to the funders. |
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This study received ethical approval from the Longgang District Maternity and Child Healthcare Hospital Research Ethics Committee (No. LGFYYXLL-2022-001). All participants signed the written informed consent. |
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The data that support the findings of this study are available from the corresponding author on reasonable request. |
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Cite this article as: Deng Y, Wu Q, Tan X, et al. Twenty-four-hour urinary protein excretion in uncomplicated singleton pregnancy. Am J Obstet Gynecol 2023;XX:x.ex–x.ex. |
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