Medical literature suggests that obesity increases proteinuria in nonpregnant populations. Our goal was to investigate proteinuria in obese versus non-obese gravidas which could possibly confound preeclampsia diagnoses.
A dataset utilizing electronic medical records from April 2009–March 2014 was constructed. Women of normal and obese BMIs, with singleton gestations, and having 24-hour urine urine and/or urine protein:creatinine results available in the third trimester were included. Exclusions were pregestational diabetes, renal disease, chronic hypertension and preeclampsia with severe features. Complete chart review was performed in cases of borderline proteinuria (250–400 mg) to document preeclampsia criteria.
EMR search identified 3,869 records. Analytical cohort included 987 subjects after application of exclusionary criteria and elimination of multiple results. Of women with 24-hour urine protein measurements, those with normal BMIs (n=409; 385±647 mg/day) did not have a significant difference in mean proteinuria measurement compared to those with obese BMIs (n=399; 376±541 mg/day) (P=.30). Of women with a urine protein:creatinine, those with normal BMI (n=69, 535±956 mg/g) had significantly increased proteinuria compared to obese women (n=71; 380±956 mg/g, P=.03). Of the 199 women with borderline proteinuria, 59 (29.6%) met criteria for preeclampsia by both blood pressures and proteinuria and 20 (10.1%) also had symptoms such as cerebral disturbances, epigastric pain and/or lab abnormalities.
Our findings did not demonstrate increased proteinuria in obese gravidas thus noting inconsistency with literature on non-pregnant populations. Study limitations include retrospective design with evaluation late in pregnancy. Further investigation is warranted prospectively in early pregnancy.
University of Massachusetts Medical School, Worcester, MA
Financial Disclosure: Dr. Moore Simas (Director, Research Division, Dept Ob/Gyn, University of Massachusetts Medical School) disclosed the following—AbbVie: Other Research Support includes receipt of drugs, supplies, equipment or other in-kind support, Research Grant includes principal investigator, collaborator or consultant and pending grants as well as grants already received. The other authors did not report any potential conflicts of interest.