The eGFRcystatin C/eGFRcreatinine-ratio is associated with maternal morbidity in hypertensive disorders in pregnancy and may indicate optimal timing of delivery.

IF 1.3 4区 医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Scandinavian Journal of Clinical & Laboratory Investigation Pub Date : 2024-10-18 DOI:10.1080/00365513.2024.2417379
Danielle Damm, Anders Grubb, Helena Strevens
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Abstract

A low eGFRcystatin C/eGFRcreatinine-ratio is characteristic of a group of serious kidney disorders called 'Selective Glomerular Hypofiltration Syndromes'. This study examines if such a low ratio can also be used to evaluate the risk for women with hypertensive disorders in pregnancy to develop severe maternal morbidity. All women discharged from the perinatal ward at the Skåne University Hospital in Lund during the period of 1-9-2016 to 31-8-2017 under one of the diagnoses within hypertensive disorders in pregnancy were considered for inclusion in the study. After delivery and discharge from the hospital, records from included patients were reviewed and all registered measures of renal function were analysed. An eGFRcystatin C/eGFRcreatinine-ratio ≤0.60 in a sample drawn not earlier than three days before delivery was considered as defining a high risk for severe maternal morbidity. A strong association (p-value: 0.035) between severe maternal morbidity and an eGFRcystatin C/eGFRcreatinine-ratio ≤0.60 was found in a subgroup of 32 women diagnosed with 'preeclampsia with severe features'. A total of 69 women were included in the study. Fifty were defined as high-risk and seventeen of them (34%) developed severe maternal morbidity. Among the nineteen women defined as low-risk only two (10.5%) developed severe maternal morbidity (p-value: 0.051). A low eGFRcystatin C/eGFRcreatinine-ratio seems promising as a predictive marker for maternal morbidity in hypertension in pregnancy. Its performance as a tool in the monitoring of progressing disease should be evaluated further in larger cohorts. Delivery before the eGFRcystatin C/eGFRcreatinine-ratio decreases to, or below, 0.60 might help avoid maternal complications.

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eGFRcystatin C/eGFRcreatinine-ratio 与妊娠期高血压疾病的孕产妇发病率有关,可指示最佳分娩时间。
eGFRcystatin C/eGFRcreatinine 比率低是一组被称为 "选择性肾小球低滤过综合征 "的严重肾脏疾病的特征。本研究探讨了这种低比率是否也可用于评估妊娠期高血压疾病妇女患严重孕产妇疾病的风险。在2016年9月1日至2017年8月31日期间,所有从隆德斯科纳大学医院围产病房出院并被诊断为妊娠期高血压疾病的产妇均被纳入研究范围。在分娩和出院后,对纳入患者的病历进行复查,并对所有登记的肾功能指标进行分析。在不早于分娩前三天抽取的样本中,eGFR胱抑素C/eGFR肌酐比值≤0.60被认为是孕产妇严重发病的高危因素。在 32 名被诊断为 "重度子痫前期 "的产妇分组中发现,重度产妇发病率与 eGFRcystatin C/eGFRcreatinine-ratio ≤0.60 之间存在密切联系(p 值:0.035)。共有 69 名妇女被纳入研究。其中 50 人被定义为高危产妇,其中 17 人(34%)出现了严重的孕产妇并发症。在被定义为低风险的 19 名产妇中,只有两人(10.5%)出现了严重的孕产妇发病率(P 值:0.051)。低 eGFR胱抑素 C/eGFR肌酐比值似乎有望成为妊娠高血压孕产妇发病率的预测指标。其作为监测疾病进展的工具的性能应在更大的队列中进一步评估。在 eGFRcystatin C/eGFRcreatinine-ratio 下降到或低于 0.60 之前分娩可能有助于避免孕产妇并发症。
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来源期刊
CiteScore
3.50
自引率
4.80%
发文量
85
审稿时长
4-8 weeks
期刊介绍: The Scandinavian Journal of Clinical and Laboratory Investigation is an international scientific journal covering clinically oriented biochemical and physiological research. Since the launch of the journal in 1949, it has been a forum for international laboratory medicine, closely related to, and edited by, The Scandinavian Society for Clinical Chemistry. The journal contains peer-reviewed articles, editorials, invited reviews, and short technical notes, as well as several supplements each year. Supplements consist of monographs, and symposium and congress reports covering subjects within clinical chemistry and clinical physiology.
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