24 Hours Ambulatory Blood Pressure Monitoring、Quantification Of Urine Protein And Adverse Pregnancy Outcomes In Women With Preeclampsia

ObjectiveThe purpose of this study was to analyze the relationship between 24 hoursambulatory blood pressure monitoring 、 quantification of urine protein andadverse pregnancy outcomes in women with preeclampsia. To investigate thecorrelation of the 24 hours urine protein and the urine protein to creatinine ratio.Methods1. A total of 59 women with preeclampsia were included in this study. All were admitted to Fujian Maternity and Child Health Hospital for delivery from January 2014 to February 2015.2. According to whether or not complicated with adverse pregnancy outcomes, patients with preeclampsia were divided into the study group( complicated with adverse pregnancy outcomes) and the control group( not complicated with adverse pregnancy outcomes).3. The parameters of 24 hours blood pressure monitoring、24 hours urine protein were compared between the two groups. The correlation of each parameters of the 24 hours blood pressure monitoring and the fetal birth weight 、 the level of lactic dehydrogenase、the 24 hours urine protein were analyzed. The correlation of parameters of the 24 hours urine protein and the fetal birth weight 、the level of lactic dehydrogenase were analyzed. We also calculated the correlation coefficient of the 24 hours urine protein and the urinary protein to creatinine ratio.Results1. The average gestation week at delivery was earlier, and the fetal birth weight was markedly lower in the study group as compared to the control group, the level of LDH 、 the incidence of early-onset preeclampsia and the incidence of iatrogenic preterm delivery were markedly higher in the study group than the control group(P <0.05).2. The highest DBP for 24 hours、d DBP、n DBP、24h DBP、d MAP、24h MAP were significantly higher in the study group as compared to the control group(P<0.05).The differences between the highest SBP for 24 hours、d SBP、n SBP、24h SBP、n MAP were not statistically significant. in the two groups were not significant(P>0.05).3. The nocturnal blood pressure decrease rate and the blood pressure variability were similar between the two groups(P > 0.05).4. The mean 24 hours urine protein of the study group was significantly higher when compared to the control group(3151.06 mg vs 1191.48 mg, P<0.001).5. The 24 h urine protein and urinary protein to creatinine ratio had a positive correlatio(rs=0.769,P<0.05).6. The d SBP、d DBP、n SBP、n DBP、24h SBP、24h DBP、d MAP、n MAP、24h MAP、the highest SBP for 24 hours、the highest DBP for 24 hours had negative correlations with fetal birth weight( P < 0.05), the correlation coefficient was numerically higher for 24 h MAP. The correlations between the blood pressure decrease rate、the blood pressure variability and the fetal birth weight were not significant(P>0.05)7. The n DBP had a positive correlation with the level of lactic dehydrogenase(P< 0.05), the nocturnal diastolic blood pressure decrease rate had a negative correlation with the level of lactic dehydrogenase(P<0.05).8. The highest DBP for 24 hours、d DBP、n DBP、24h DBP、d MAP、n MAP、24h MAP had positive correlations with the 24 hours urine protein(P<0.05), the correlation coefficient was numerically higher for 24 hours highest DBP. The correlations between other parameters of 24 h ABPM and the 24 hours urine protein were not significant(P>0.05).9. The fetal birth weight had a negative correlation with the 24 hours urine protein(P< 0.05), the level of lactic dehydrogenase had a positive correlation with the 24 hours urine protein(P<0.05).Conclusions1. The average parameters of 24 h ABPM had a closely relationship with adverse pregnancy outcomes in preeclampsia patients, especially for the average DBP parameters of 24 h ABPM2. The n DBP of 24 h ABPM and the nocturnal diastolic blood pressure decrease rate played an important role in predicting the risk of adverse pregnancy outcomes in preeclampsia patients.3. The 24 hours urine protein associated with adverse pregnancy outcomes in patients with preeclampsia.4. The 24 hours urine protein and random urinary protein to creatinine ratio had a good correlation, the urinary protein to creatinine ratio could be a alternative to the 24 hours urine protein.