Does microalbuminuria at mid-pregnancy predict development of subsequent pre-eclampsia?

Aim: 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. Material and Methods: This prospective observational study was carried out on 144 normotensive women, aged < 35 years, body mass index < 25 kg/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. Conclusion: Microalbuminuria in mid-pregnancy may be a significant predictor of development of subsequent pre-eclampsia, preterm birth and low-birthweight babies. [ABSTRACT FROM AUTHOR]