First-trimester urinary protein levels and adverse pregnancy outcomes in low-risk women: implications for reassessing clinical thresholds

Objective To evaluate the association between first-trimester 24-h urinary protein levels (50–300 mg) and maternal/perinatal outcomes in low-risk pregnancies, focusing on subthreshold proteinuria (150–300 mg/24 h).Methods A retrospective cohort study analyzed 237 low-risk pregnant women with singlet...

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Bibliographic Details
Main Authors: Lei Cai, Lan Zhu, Yan Liu, Chenmin Yang
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:The Journal of Maternal-Fetal & Neonatal Medicine
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Online Access:https://www.tandfonline.com/doi/10.1080/14767058.2025.2528060
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Summary:Objective To evaluate the association between first-trimester 24-h urinary protein levels (50–300 mg) and maternal/perinatal outcomes in low-risk pregnancies, focusing on subthreshold proteinuria (150–300 mg/24 h).Methods A retrospective cohort study analyzed 237 low-risk pregnant women with singleton gestations and first-trimester urinary protein levels of 50–300 mg/24 h at Ruijin Hospital (2015–2020). Participants were stratified into two groups: 50–150 mg/24 h (n = 158) and 150–300 mg/24 h (n = 79).Results Women with 150–300 mg/24 h proteinuria exhibited significantly higher systolic blood pressure (123.1 vs. 119.1 mmHg, p < 0.05) and mean arterial pressure (92.3 vs. 89.7 mmHg, p < 0.05). Women with urinary protein 150 ∼ 300mg/24 h were more likely to develop gestational hypertension (11.4% compared with 4.4%), preeclampsia (6.3% compared with 0), compared with women with urinary protein 50 mg–150 mg/24 h. The proportions of FGR, preterm, low birth weight infants were increased in the group with urinary protein 150 ∼ 300mg/24 h compared with the group with urine protein 50 ∼ 150mg/24h (6.3% VS 0.63%, 20.3% VS 8.2%, 12.7% VS 3.2%, p < 0.05).Conclusion Even within the conventional ‘normal’ range (<300 mg/24 h), first-trimester urinary protein levels of 150–300 mg/24 h are associated with increased risks of hypertensive disorders and adverse perinatal outcomes.
ISSN:1476-7058
1476-4954