title: Clinical features of isolated gestational proteinuria progressing to pre-eclampsia: retrospective observational study.
abstract: OBJECTIVE
  Some women with isolated gestational proteinuria (IGP) later develop hypertension and are diagnosed with pre-eclampsia (PE). This study was performed to determine whether clinical features of such proteinuria preceding PE (P-PE) differ from those of other PE (O-PE).
  
  
  METHODS
  Retrospective observational study after approval of the institutional review board of ethics.
  
  
  METHODS
  A single university hospital. Proteinuria was defined as a protein-to-creatinine ratio (mg/mg; P/Cr) of ≥0.27 in the spot urine specimen. IGP was defined as proteinuria in the absence of hypertension. P-PE was defined as PE in which proteinuria preceded hypertension by more than 2 days.
  
  
  METHODS
  All of 10 and 18 consecutive women with P-PE and O-PE, respectively, who gave birth between January 2008 and August 2013.
  
  
  RESULTS
  Proteinuria appeared earlier (at 30.2±3.0 vs 35.3±4.3 weeks, p=0.001), the P/Cr level was greater at birth (7.28±2.14 vs 3.19±2.49, p<0.001), net maternal weight gain during the last antenatal 1 week was greater (3.1±1.8 vs 1.3±1.7 kg, p=0.023) and length of pregnancy was shorter (32.5±1.9 vs 36.1±3.6 weeks, p=0.001) in women with P-PE than in O-PE. The duration of IGP was 10.0±5.9 days (range 3-20), and the time interval until delivery after diagnosis of PE was 6.1±8.2 days (range 0-23) in 10 women with P-PE. The P/Cr levels at birth were significantly inversely correlated with the antenatal lowest antithrombin activity and fibrinogen levels among the 28 women with PE.
  
  
  CONCLUSIONS
  Women with P-PE were likely to exhibit greater proteinuria in the urine, greater water retention in the interstitial space and more enhanced coagulation-fibrinolysis, thus suggesting that they may constitute a more severe form of PE than women with O-PE do.
authors.affiliation: Department of Obstetrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Rina
authors.initials: R
authors.lastname: Akaishi
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yamada
authors.forename: Mamoru
authors.initials: M
authors.lastname: Morikawa
authors.forename: Ryutaro
authors.initials: R
authors.lastname: Nishida
authors.forename: Hisanori
authors.initials: H
authors.lastname: Minakami
mesh_terms: D000328:Adult; D018450:Disease Progression; D005260:Female; D006801:Humans; D011225:Pre-Eclampsia / Q000175:diagnosis* / Q000652:urine; D011247:Pregnancy; D011248:Pregnancy Complications; D011507:Proteinuria / Q000150:complications*; D012189:Retrospective Studies; D013997:Time Factors
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