title: Does microalbuminuria at mid-pregnancy predict development of subsequent pre-eclampsia?
abstract: OBJECTIVE
  The aim of this study was to evaluate microalbuminuria at mid-pregnancy, using the albumin-to-creatinine ratio (ACR), as a predictor of pre-eclampsia.
  
  
  METHODS
  This prospective observational study was carried out on 144 normotensive women, aged<35 years, body mass index<25kg/m², and live singleton pregnancy between 24 and 28 weeks. In all, the ACR was measured in spot random urine samples. Normoalbuminuria was an ACR of <30 mg/g, whereas microalbuminuria was an ACR of 30-299 mg/g creatinine. All were followed till delivery. Primary outcome was the development of pre-eclampsia. The secondary outcome measures were preterm births and neonatal birthweight. Statistical analysis was done with Fisher's exact and t-tests.
  
  
  RESULTS
  Of all, 77.1% (111/144) had normoalbuminuria and 22.9% (33/144) had microalbuminuria. Of 33 microalbuminuric women, the mean blood pressure was significantly higher in those who subsequently developed pre-eclampsia (P<0.001). The mean ACR (mg/g) in this cohort was 60.6±29.4. The mean ACR (mg/g) in women who subsequently developed pre-eclampsia was significantly higher than in women who remained normotensive (P=0.003). Of 33 microalbuminuric women, 12 (36.4%) developed pre-eclampsia, and eight (24.2%) had preterm births. The mean birthweight (kg±standard deviation) was significantly lower in the microalbuminuria group (2.45±0.6) as compared to the normoalbuminuria group (2.8±0.37), P<0.001.
  
  
  CONCLUSIONS
  Microalbuminuria in mid-pregnancy may be a significant predictor of development of subsequent pre-eclampsia, preterm birth and low-birthweight babies.
authors.affiliation: Departments of Obstetrics and Gynecology, Chhatrapati Shahuji Maharaj Medical University, Lucknow, India. narayanrenu@yahoo.com
authors.forename: Renu
authors.initials: R
authors.lastname: Singh
authors.forename: Indu
authors.initials: I
authors.lastname: Tandon
authors.forename: Sujata
authors.initials: S
authors.lastname: Deo
authors.forename: Shankar Madhav
authors.initials: SM
authors.lastname: Natu
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000453:epidemiology / Q000503:physiopathology* / Q000652:urine; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D011225:Pre-Eclampsia / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000503:physiopathology* / Q000652:urine; D011262:Pregnancy Trimester, Second; D047928:Premature Birth / Q000453:epidemiology / Q000209:etiology; D015995:Prevalence; D011446:Prospective Studies; D055815:Young Adult