When Pregnancy Is Complicated by Preexisting Hypertension plus Proteinuria

A growing number of reproductive-aged women require treatment for hypertension that may be complicated by proteinuria. To assess the usefulness of 24-hour urinary protein levels (measured before 20 weeks' gestation) in predicting risk for adverse perinatal outcomes, investigators at an academic hospital in Texas conducted a retrospective cohort study involving 447 pregnant women who had been treated for hypertension prior to pregnancy and who delivered between 2002 and 2014.

Those women with proteinuria ≥300 mg/day (the conventional definition of abnormal elevation) were significantly more likely than those with proteinuria below 300 mg/day to develop preeclampsia (79% vs. 49%), deliver before 30 weeks' gestation (18% vs. 6%), and deliver a …