Prevalence of Microalbuminuria in Pregnancy and its Predictive Value for Development of Pregnancy Induced Hypertension at a Tertiary Care Hospital in Nepal: A Longitudinal Observation Study


Authors : Dr.Dikchhya Khanal; Dr. Den Prasad Acharya; Dr. Soni Shrestha; Dr. Sanjay Shrestha; Dr. Nanda Kishwor Chaudhary

Volume/Issue : Volume 6 - 2021, Issue 7 - July

Google Scholar : http://bitly.ws/9nMw

Scribd : https://bit.ly/3g94e6s

Introduction: Hypertensive disorders in pregnancy contribute significantly to the maternal mortality, premature birth, intrauterine growth retardation and perinatal mortality. Objectives: This study is done to determine if microalbuminuria can be used as a predictive marker of pregnancy induced hypertension (PIH) and adverse pregnancy and neonatal outcomes. Materials and Methods: This study was hospital based longitudinal observational done in pregnant women attending antenatal clinic in B.P. Koirala Institute of Health Sciences for a period of 1 year from January, 2017 to January, 2019. This study involved total of 504 women of gestational age 24-28 weeks, were evaluated for microalbuminuria, defined by spot urine albumin creatinine ratio 30-300 mg/g (Kidney Disease Improving Global Outcomes guidelines) and followed till discharge after delivery. Development of PIH and both maternal and fetal outcome were recorded. Results: Of the 504 patients pregnant women enrolled in our study, 89 (17.7%) had microalbuminuria. The rate of development of PIH was significantly higher in microalbuminuric women compared to non microalbuminuric (p <0.05). The Sensitivity, Specificity, Positive Predictive Value and Negative Predictive Value of micro-albuminuria in predicting occurrence of PIH during Pregnancy was found to be 42.86%, 84.22%, 16.85% and 95.18% respectively. Conclusion: The absence of microalbuminuria was highly specific for predicting nonoccurrence of PIH during the pregnancy. However, microalbuminuria had low sensitivity for the screening of PIH and hence poor predictive value.

Keywords : Hypertension, Microalbuminuria, Pregnancy

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