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Association between hypoproteinaemia with massive proteinuria and small for gestational age in pre-eclampsia: a single-centre, retrospective cohort study using propensity score matching.


ABSTRACT:

Objective

To investigate the association between hypoproteinaemia with massive proteinuria and the incidence of small for gestational age in pre-eclampsia.

Design

Retrospective cohort study using propensity score matching.

Setting

Northwest Women's and Children's Hospital in Shaanxi Province, China, using data from January 2016 to December 2021.

Participants

Patients diagnosed with pre-eclampsia were grouped into the massive proteinuria group if the maximum proteinuria was >3.5 g/day and the minimum serum albumin was <30 g/L; otherwise, they were placed in the control group.

Outcome measures

The primary outcome was the incidence of small for gestational age infants. Secondary outcomes included fetal death, admission to the neonatal intensive care unit, a 5 min APGAR score <7, severe small for gestational age, fetal growth restriction, birth weight, premature birth, and maternal outcomes such as eclampsia, encephalopathy, placental abruption, haemolysis, elevated liver enzymes and low platelet syndrome, heart failure and retinal detachment.

Results

In total, 468 patients (234 from each group) were included, and the groups were well matched. The incidences of small for gestational age (33.76% vs 20.51%, OR 1.646, 95% CI 1.208 to 2.243, p=0.001), severe small for gestational age (14.70% vs 7.69%, OR 1.833, 95% CI 1.063 to 3.162, p=0.026), fetal growth restriction (23.93% vs 16.24%, OR 1.474, 95% CI 1.018 to 2.133, p=0.038), and the numbers of infants admitted to the neonatal intensive care unit (67.52% vs 58.55%, OR 1.153, 95% CI 1.003 to 1.326, p=0.044) were significantly higher in patients with hypoproteinaemia and massive proteinuria than in the control group. In addition, the median birth weight was significantly lower in the massive proteinuria group. There were no significant differences in maternal outcomes except for renal parameters, which were worse in the massive proteinuria group.

Conclusion

Hypoproteinaemia with massive proteinuria was associated with fetal growth and a higher incidence of small for gestational age infants in pre-eclampsia.

SUBMITTER: Lv Y 

PROVIDER: S-EPMC10357757 | biostudies-literature | 2023 Jul

REPOSITORIES: biostudies-literature

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Publications

Association between hypoproteinaemia with massive proteinuria and small for gestational age in pre-eclampsia: a single-centre, retrospective cohort study using propensity score matching.

Lv Yanxiang Y   Zhou Ying Y   Hu Rui R   Liang Yan Y   Lian Yanan Y   Wang Jun J   Wei Yang Y   Zhang Yanmei Y   Qiao Yuan Y   He Tongqiang T   He Tongqiang T  

BMJ open 20230718 7


<h4>Objective</h4>To investigate the association between hypoproteinaemia with massive proteinuria and the incidence of small for gestational age in pre-eclampsia.<h4>Design</h4>Retrospective cohort study using propensity score matching.<h4>Setting</h4>Northwest Women's and Children's Hospital in Shaanxi Province, China, using data from January 2016 to December 2021.<h4>Participants</h4>Patients diagnosed with pre-eclampsia were grouped into the massive proteinuria group if the maximum proteinur  ...[more]

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