Document Detail

Maternal urine albumin excretion and pregnancy outcome.
MedLine Citation:
PMID:  15957129     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Vascular dysfunction has been hypothesized as a causal pathway for preeclampsia, impaired fetal growth, and early parturition. The relationship between increased urine albumin excretion (albuminuria), a marker of endothelial dysfunction, and preterm birth has not been fully evaluated. METHODS: We conducted a nested case-control study of 404 pregnancies from 1998 to 2000 within the Pregnancy, Infection and Nutrition cohort. Cases consisting of live births delivered before 37 weeks of gestation (preterm birth, n = 111) were compared with term births from the same cohort (n = 293). Albumin-creatinine ratio (in milligrams per gram) was measured in urine collected around 27 weeks of gestation. We compared risks for preterm birth in mothers with albuminuria with albumin levels of 3 to 20 mg/g and greater than 20 mg/g relative to those with albumin levels less than 3 mg/g by using logistic regression. RESULTS: Median albuminuria was albumin level of 2.7 and 4.3 mg/g for term and preterm births, respectively. Albuminuria was strongly associated with preterm birth in a dose-response fashion, with adjusted odds ratios of 1.9 (95% confidence interval, 1.1 to 3.1) and 4.7 (95% confidence interval, 1.7 to 12.6) for albuminuria with albumin of 3 to 20 mg/g and greater than 20 mg/g, respectively. The association was present for both spontaneous and medically induced preterm births, but the effect was decreased and the dose-response relationship was eliminated by excluding high-risk groups and those with pregnancy complications. CONCLUSION: Low levels of albuminuria are associated with preterm birth. The mechanism underlying this association warrants additional exploration.
Nora Franceschini; David A Savitz; Jay S Kaufman; John M Thorp
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American journal of kidney diseases : the official journal of the National Kidney Foundation     Volume:  45     ISSN:  1523-6838     ISO Abbreviation:  Am. J. Kidney Dis.     Publication Date:  2005 Jun 
Date Detail:
Created Date:  2005-06-15     Completed Date:  2005-10-21     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8110075     Medline TA:  Am J Kidney Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1010-8     Citation Subset:  IM    
Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, NC 27599-7155, USA.
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MeSH Terms
African Americans / statistics & numerical data
Albuminuria / epidemiology*
Case-Control Studies
Cohort Studies
Endothelium, Vascular / physiopathology
European Continental Ancestry Group / statistics & numerical data
Hypertension / epidemiology
Hypertension, Pregnancy-Induced / epidemiology
Infant, Newborn
Infant, Premature
Labor, Induced / statistics & numerical data
North Carolina / epidemiology
Obesity / epidemiology
Obstetric Labor, Premature / epidemiology
Pre-Eclampsia / epidemiology
Predictive Value of Tests
Pregnancy Complications / epidemiology*
Pregnancy Outcome*
Pregnancy Trimester, Third
Smoking / epidemiology
Grant Support

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