Presented at the Neonatal Society 2005 Spring Meeting.
Roy C1, Broughton-Pipkin F2, Waugh J1
1 Obstetrics & Gynaecology, Leicester Royal Infirmary, Kensington Building, Leicester LE1 5WW, UK
2 School of Human Development, University of Nottingham, Queen’s Medical Centre, Nottingham NG7 2UH, UK
Introduction: PE is a common obstetric condition that can prove hazardous to the fetus. Microalbuminuria is known to be an indicator for underlying vascular damage in the adult, yet there are no follow-up studies on these babies. We have studied prospectively a cohort of babies born to strictly defined PE mothers, exact gestation matched controls (GC) and term controls (TC).
Methods: 17 PE, GC and TC babies have been studied to 6 months. Mothers were instructed to collect a 24-hour collection of nappies at 3 and 6 months postnatal age. The urine was extracted by compression after equilibration in 4% saline for 24 hours at 4ºC (1). Urine protein, protein/creatinine ratio (PCR), albumin and albumin/creatinine ratio (ACR) were measured by the biochemistry department at the Leicester Royal Infirmary. Ethical approval was obtained from the University Hospitals of Leicester NHS Trust ethics department. Data were analysed with SPSS.
Results: Given as median + IQR.
Gestation at delivery: PE 36 (34-40), GC 36 (34-40), TC 39 (39-40).
Discussion: Previous studies have demonstrated that creatinine clearance is significantly decreased in preterm babies and that serum creatinine is raised. This may be due to an intra-uterine hypoxic insult (2) or back-flow of creatinine across immature tubules (3). Our results indicate that PE may protect against this initially, possibly mediated through enhanced tubular maturation through exposure to cortisol, which is raised in PE.
References
1. Taylor NF and Curran I. Proceedings of ACB National Meeting, Brighton 1994; Abstract C35.
2. Arad I, Bar-Oz B, Peleg O. Twin Res 2001; 4(4): 215-8.
3. Guignard J and Drukker A. Pediatrics 1999; 103: 49-52.