The Interval Between Elevation of Blood Pressure and Proteinuria in Preeclampsia and Contributing Factors.

Abstract

Abstract Purpose: The new-onset proteinuria, as a pivotal sign for the representative renal lesion in preeclampsia, is still the most common diagnostic basis and has been proved relevant to the significantly abnormal sFlt-1/VEGF ratio in circulation. At the same time, the blood pressure control plays an vital role in the occurrence and evolution of proteinuria. Therefore, it is particularly helpful to investigate their internal for not only performing urinalysis for protein more legitimately but also evaluating the blood pressure level as well as the aggravation of illness, while the related research is limited. Methods:This retrospective study included 515 preeclampsia and 358 normotensive pregnancies who labored in the Second Hospital of Tianjin Medical University from January 2016 to January 2020. At first, we described the onset circumstance of high blood pressure and proteinuria as well as the internal among the case group and the subgroups. Then, we decided the significant difference of the materials about the basic information, laboratory tests as well as the newborns between the case and normal group. Finally, the multi-factor ANOVA was used for the influencing factors of the internal. Results:1. The two most common complications in preeclampsia were the proteinuria (88.35%) and placental dysfunction (5.05%). Moreover, 77.86% preeclampsia was diagnosed by abnormal blood pressure together with the new-onset proteinuria. 2.The average internal between the high blood pressure and proteinuria was 22 gestational days (from 0 to 106 days), and this interval was not significantly different between the mild and severe PE (26 days vs 21 days, P>0.05) but significantly different between the early-onset and late-onset PE (9 days vs 28 days, P<0.05). 3. The times of prenatal visit, serum creatinine in the early trimester, gestational time and diastolic blood pressure value when the initial high blood pressure appeared may influence the interval between the high blood pressure and proteinuria. Conclusion:The new-onset proteinuria was still the prime parameter for identifying preeclampsia. The interval between the high blood pressure and proteinuria was probably relevant to the unbalance of sFlt-1/VEGF ratio and we should pay attention to monitor the proteinuria during the prenatal visit, especially for the pregnancies with less frequency of prenatal visits, higher serum creatinine in the early trimester, earlier onset time and higher diastolic blood pressure as the initial high blood pressure happened.