Forecasting Adverse Pregnancy Outcomes in the Setting of Chronic Hypertension

Hypertension, which can cause renal insufficiency, affects a growing number of reproductive-aged women. To quantify the relation between renal function in early pregnancy and later development of preeclampsia, researchers conducted a retrospective cohort study involving 755 pregnant women with chronic hypertension who had renal function tests before 20 weeks' gestation.

In all, 739 participants had “normal” serum creatinine levels (<1.2 mg/dL). However, when compared with women who had serum creatinine below an objective cutoff of 0.75 mg/dL, those with serum creatinine ≥0.75 mg/dL were more than three times as likely to develop severe preeclampsia before 34 weeks' gestation. Elevated urine protein-to-creatinine (PC) ratios further raised ri…