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Is the first urinary albumin/creatinine ratio (ACR) in women with suspected preeclampsia a prognostic factor for maternal and neonatal adverse outcome? A retrospective cohort study

INTRODUCTION: The aim of this study was to determine the prognostic value of the first urinary albumin/creatinine ratio (ACR) for adverse maternal and neonatal outcomes and how it relates to other prognostic factors. MATERIAL AND METHODS: We performed a retrospective cohort study from December 2009...

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Autores principales: Elia, Eleni G., Robb, Amy O., Hemming, Karla, Price, Malcolm J., Riley, Richard D., French‐Constant, Anna, Denison, Fiona C., Kilby, Mark D., Morris, Rachel K., Stock, Sarah J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5413808/
https://www.ncbi.nlm.nih.gov/pubmed/28247485
http://dx.doi.org/10.1111/aogs.13123
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author Elia, Eleni G.
Robb, Amy O.
Hemming, Karla
Price, Malcolm J.
Riley, Richard D.
French‐Constant, Anna
Denison, Fiona C.
Kilby, Mark D.
Morris, Rachel K.
Stock, Sarah J.
author_facet Elia, Eleni G.
Robb, Amy O.
Hemming, Karla
Price, Malcolm J.
Riley, Richard D.
French‐Constant, Anna
Denison, Fiona C.
Kilby, Mark D.
Morris, Rachel K.
Stock, Sarah J.
author_sort Elia, Eleni G.
collection PubMed
description INTRODUCTION: The aim of this study was to determine the prognostic value of the first urinary albumin/creatinine ratio (ACR) for adverse maternal and neonatal outcomes and how it relates to other prognostic factors. MATERIAL AND METHODS: We performed a retrospective cohort study from December 2009 to February 2012 with analysis of demographic, clinical and biochemical data from two obstetric day assessment units in hospitals in Southeast Scotland. We included 717 pregnant women, with singleton pregnancies after 20 weeks’ gestation, referred for evaluation of suspected preeclampsia and having their first ACR performed. The ability of ACR to predict future outcomes was assessed in both univariable and multivariable logistic regression models. The latter assessed its prognostic value independent of (adjusting for) existing prognostic factors. Primary outcome measures were maternal and neonatal composite adverse outcomes, and a secondary outcome was gestation at delivery. RESULTS: In all, 204 women (28.5%) experienced a composite adverse maternal outcome and 146 women (20.4%) experienced a composite adverse neonatal outcome. Multivariate analysis of log‐transformed ACR demonstrated that a 1‐unit increase in log ACR is associated with an increased odds of adverse maternal [odds ratio 1.60, 95% confidence interval (CI) 1.45–1.80] and adverse neonatal (odds ratio 1.15, 95% CI 1.02–1.29) composite outcomes, and with reduced gestational age at delivery (coefficient: −0.46, 95% CI −0.54 to −0.38). CONCLUSIONS: ACR is an independent prognostic factor for maternal and neonatal adverse outcomes in suspected preeclampsia. ACR may be useful to inform risk predictions within a prognostic model.
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spelling pubmed-54138082017-05-15 Is the first urinary albumin/creatinine ratio (ACR) in women with suspected preeclampsia a prognostic factor for maternal and neonatal adverse outcome? A retrospective cohort study Elia, Eleni G. Robb, Amy O. Hemming, Karla Price, Malcolm J. Riley, Richard D. French‐Constant, Anna Denison, Fiona C. Kilby, Mark D. Morris, Rachel K. Stock, Sarah J. Acta Obstet Gynecol Scand Pregnancy INTRODUCTION: The aim of this study was to determine the prognostic value of the first urinary albumin/creatinine ratio (ACR) for adverse maternal and neonatal outcomes and how it relates to other prognostic factors. MATERIAL AND METHODS: We performed a retrospective cohort study from December 2009 to February 2012 with analysis of demographic, clinical and biochemical data from two obstetric day assessment units in hospitals in Southeast Scotland. We included 717 pregnant women, with singleton pregnancies after 20 weeks’ gestation, referred for evaluation of suspected preeclampsia and having their first ACR performed. The ability of ACR to predict future outcomes was assessed in both univariable and multivariable logistic regression models. The latter assessed its prognostic value independent of (adjusting for) existing prognostic factors. Primary outcome measures were maternal and neonatal composite adverse outcomes, and a secondary outcome was gestation at delivery. RESULTS: In all, 204 women (28.5%) experienced a composite adverse maternal outcome and 146 women (20.4%) experienced a composite adverse neonatal outcome. Multivariate analysis of log‐transformed ACR demonstrated that a 1‐unit increase in log ACR is associated with an increased odds of adverse maternal [odds ratio 1.60, 95% confidence interval (CI) 1.45–1.80] and adverse neonatal (odds ratio 1.15, 95% CI 1.02–1.29) composite outcomes, and with reduced gestational age at delivery (coefficient: −0.46, 95% CI −0.54 to −0.38). CONCLUSIONS: ACR is an independent prognostic factor for maternal and neonatal adverse outcomes in suspected preeclampsia. ACR may be useful to inform risk predictions within a prognostic model. John Wiley and Sons Inc. 2017-03-24 2017-05 /pmc/articles/PMC5413808/ /pubmed/28247485 http://dx.doi.org/10.1111/aogs.13123 Text en © 2017 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG). This is an open access article under the terms of the Creative Commons Attribution (http://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Pregnancy
Elia, Eleni G.
Robb, Amy O.
Hemming, Karla
Price, Malcolm J.
Riley, Richard D.
French‐Constant, Anna
Denison, Fiona C.
Kilby, Mark D.
Morris, Rachel K.
Stock, Sarah J.
Is the first urinary albumin/creatinine ratio (ACR) in women with suspected preeclampsia a prognostic factor for maternal and neonatal adverse outcome? A retrospective cohort study
title Is the first urinary albumin/creatinine ratio (ACR) in women with suspected preeclampsia a prognostic factor for maternal and neonatal adverse outcome? A retrospective cohort study
title_full Is the first urinary albumin/creatinine ratio (ACR) in women with suspected preeclampsia a prognostic factor for maternal and neonatal adverse outcome? A retrospective cohort study
title_fullStr Is the first urinary albumin/creatinine ratio (ACR) in women with suspected preeclampsia a prognostic factor for maternal and neonatal adverse outcome? A retrospective cohort study
title_full_unstemmed Is the first urinary albumin/creatinine ratio (ACR) in women with suspected preeclampsia a prognostic factor for maternal and neonatal adverse outcome? A retrospective cohort study
title_short Is the first urinary albumin/creatinine ratio (ACR) in women with suspected preeclampsia a prognostic factor for maternal and neonatal adverse outcome? A retrospective cohort study
title_sort is the first urinary albumin/creatinine ratio (acr) in women with suspected preeclampsia a prognostic factor for maternal and neonatal adverse outcome? a retrospective cohort study
topic Pregnancy
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5413808/
https://www.ncbi.nlm.nih.gov/pubmed/28247485
http://dx.doi.org/10.1111/aogs.13123
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