Chronic kidney disease, Postpartum, Preeclampsia, Resolution of hypertension, Resolution of proteinuria, Serum NT-pro-BNP,Cardiovascular disease
Citation Information :
Saini V, Gupta M, Kumar DS, Singh H, Gupta S. Preeclampsia: Postpartum Resolution of Hypertension, Proteinuria and Serum N-terminal B-type Natriuretic Peptide. Indian J Med Biochem 2019; 23 (2):278-286.
Background: Postpartum persistent proteinuria and hypertension (HT) is associated with development of chronic kidney disease and cardiovascular disease in later life. AIMS & OBJECTIVES: To evaluate blood pressure, proteinuria and serum NT-pro-BNP in proteinuric preeclamptic (PE) women and study their postpartum resolution till 3 months and determine the associated risk factors.
Material and Methods: 100 PE women enrolled included 66 women with mild (group A) and 34 with severe PE (group B). BP, urinary protein:creatinine(P/C) ratio, S.NT-pro-BNP were evaluated at labor room admission, postpartum day 1, 6 weeks and 3 months.
Results: Group B women had significant higher baseline BP, urine P/C ratio and S. NT-pro-BNP compared to group A. Resolution of BP, proteinuria and S. NT-pro-BNP was complete in group A women at 6 weeks postpartum. Persistent hypertension was observed in 25 and 4 women at postpartum 6 weeks and 3 months respectively. Proteinuria persisted in 25 and 10 women at postpartum 6 weeks and 3 months respectively. Resolution of NT-pro-BNP was complete at 3 months. In logistic regression model persisting hypertension and proteinuria at 3 months was correlated with increasing age, higher BMI and lower gestational age at delivery. Negative predictive value of 100% was observed with baseline P/C ratio <5, BP <120 mm Hg diastolic and S.NT-pro-BNP <1000 pg/mL for development of persistent proteinuria and hypertension.
Conclusion: Women with severe PE should be followed up for persistent proteinuria and hypertension. These women require evaluation for chronic kidney disease and preventive strategies for cardiovascular disease.
Center for Health Informatics (CHI), at National Institute of Health and Family Welfare (NIHFW),by Ministry of Health and Family Welfare (Mo HFW), Govt. of India. Available at https://www.nhp.gov.in/disease/gynaecology-and-obstetrics/preeclampsia
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