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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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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author Lei Cai
Lan Zhu
Yan Liu
Chenmin Yang
author_facet Lei Cai
Lan Zhu
Yan Liu
Chenmin Yang
author_sort Lei Cai
collection DOAJ
description 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.
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spelling doaj-art-878e223e165c40cba50bcf2e95dea0422025-08-20T03:29:31ZengTaylor & Francis GroupThe Journal of Maternal-Fetal & Neonatal Medicine1476-70581476-49542025-12-0138110.1080/14767058.2025.2528060First-trimester urinary protein levels and adverse pregnancy outcomes in low-risk women: implications for reassessing clinical thresholdsLei Cai0Lan Zhu1Yan Liu2Chenmin Yang3Department of Obstetrics and Gynecology, Ruijin Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, ChinaDepartment of Obstetrics and Gynecology, Ruijin Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, ChinaDepartment of Obstetrics and Gynecology, Ruijin Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, ChinaDepartment of Obstetrics and Gynecology, Ruijin Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, ChinaObjective 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.https://www.tandfonline.com/doi/10.1080/14767058.2025.2528060Urinary proteinhypertensionpreeclampsiapreterm deliverylow birth weight infant
spellingShingle Lei Cai
Lan Zhu
Yan Liu
Chenmin Yang
First-trimester urinary protein levels and adverse pregnancy outcomes in low-risk women: implications for reassessing clinical thresholds
The Journal of Maternal-Fetal & Neonatal Medicine
Urinary protein
hypertension
preeclampsia
preterm delivery
low birth weight infant
title First-trimester urinary protein levels and adverse pregnancy outcomes in low-risk women: implications for reassessing clinical thresholds
title_full First-trimester urinary protein levels and adverse pregnancy outcomes in low-risk women: implications for reassessing clinical thresholds
title_fullStr First-trimester urinary protein levels and adverse pregnancy outcomes in low-risk women: implications for reassessing clinical thresholds
title_full_unstemmed First-trimester urinary protein levels and adverse pregnancy outcomes in low-risk women: implications for reassessing clinical thresholds
title_short First-trimester urinary protein levels and adverse pregnancy outcomes in low-risk women: implications for reassessing clinical thresholds
title_sort first trimester urinary protein levels and adverse pregnancy outcomes in low risk women implications for reassessing clinical thresholds
topic Urinary protein
hypertension
preeclampsia
preterm delivery
low birth weight infant
url https://www.tandfonline.com/doi/10.1080/14767058.2025.2528060
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AT yanliu firsttrimesterurinaryproteinlevelsandadversepregnancyoutcomesinlowriskwomenimplicationsforreassessingclinicalthresholds
AT chenminyang firsttrimesterurinaryproteinlevelsandadversepregnancyoutcomesinlowriskwomenimplicationsforreassessingclinicalthresholds