Preeclampsia and prevalence of microalbuminuria 10 years later

Abstract

Background and objectives: A recent meta-analysis found that about 30% of women with a previous preeclamptic pregnancy had persistent microalbuminuria at follow-up. The analysis was, however, based on small studies, and more data are needed.

Design, setting, participants, & measurements: Using data from the Medical Birth Registry in Norway, this study identified women with or without preeclampsia in their first pregnancy 9-11 years previously (1998-2000). Women with diabetes, rheumatic disease, essential hypertension, or renal disease before first pregnancy and/or preeclampsia in later pregnancies were excluded. Eighty-nine women with and 69 women without preeclampsia participated in the study. Urinary albumin-to-creatinine ratio (ACR) was measured in three morning urine samples. Estimated GFR (eGFR) was calculated using the CKD-Epidemiology Collaboration formula.

Results: Median urinary ACR in follow-up urine samples was 0.53 mg/mmol for women with and 0.50 mg/mmol for women without preeclampsia (P=0.54). Only one woman (1%) with previous preeclampsia had urinary ACR >2.5 mg/mmol in two of three urine samples. Preeclampsia was not associated with urinary ACR above the 75th percentile. Women with preeclampsia did not have significantly higher eGFR than women without preeclampsia (107.9 versus 104.9 ml/min per 1.73 m(2); P=0.12), but preterm preeclampsia was significantly associated with eGFR above the 75th percentile (P=0.03).

Conclusions: In this population-based study of otherwise healthy women, preeclampsia 10 years earlier was not associated with increased risk of persisting microalbuminuria. Estimated GFR was not significantly different between women with and those without preeclampsia, but preterm preeclampsia was associated with high normal eGFR.

Figure 1.

Histograms of distributions of urinary albumin-to-creatinine ratios in women with and without preeclampsia. The one woman with previous preeclampsia and urinary albumin-to-creatinine ratio of 12 mg/mmol is not included in the histogram.

Figure 2.

Histograms of distributions of estimated GFR values in women without preeclampsia, with term preeclampsia, and with preterm preeclampsia.