Proteinuria in the nephrotic range in pregnant women.

A single-center observational study.

Abstract

Introduction: Physiological changes in pregnant women can be altered by the appearance of pathological phenomena such as proteinuria in the nephrotic range, relevant in the diagnosis of preeclampsia and glomerular disease. The objective of the present study was to describe the clinical characteristics and results of pregnant women with nephrotic proteinuria in a reference center in Cuba.

Methods: The present observational, prospective, longitudinal follow-up study, which lasted 12 weeks, was conducted at the Vladimir Ilich Lenin General Hospital in Holguín, Cuba, between October 2020 and September 2022. All pregnant women with proteinuria in the nephrotic range were registered. The variables were age, body mass index at pregnancy detection, gestational age, African descent, number of pregnancies, serum creatinine, proteinuria in 24 hours at the onset of symptoms, and clinical history. Descriptive statistics are presented.

Results: 48 patients entered the study. White, primigravida pregnant women predominated; the average age was 24.8 years. The average gestational time was 31.8 weeks, and serum creatinine was 94.8 µmol/L. The main personal medical history was arterial hypertension and systemic lupus erythematosus. There was no statistical association between the age groups and the persistence of proteinuria. Pregnant women with proteinuria before 20 weeks maintained it after 12 weeks postpartum, defining it as kidney disease. Pregnant women with previous high blood pressure had a 2.2 times higher risk of preeclampsia.

Conclusion: In both causal groups (preeclampsia and kidney disease), there were maternal-fetal complications, highlighting induced abortion, preterm birth, intrauterine growth retardation, and low birth weight.