The clinical value of microtransferrinuria and microalbuminuria in the prediction of pre-eclampsia

The aim of this study is to determine whether the presence of microtransfer rinuria and microalbuminuria detected in pregnant women who are free of sym ptoms can predict the subsequent development of preeclampsia. One hundred f ifty five pregnant women were successfully followed from 10 weeks gestation up till delivery. Pre-eclampsia developed in 31 women (17 mild and 12 seve re pre-eclampsia), and eclampsia developed in two cases, whereas 124 women remained normotensive (controls). First morning urine specimens were collec ted during 10 to 12 weeks gestation and analyzed for microalbuminuria by a specific immunochemical test strip method. Mid-trimester mean arterial bloo d pressure (MAP) was also measured. Urinary microtransferrin levels in preg nant women who subsequently developed severe pre-eclampsia and eclampsia we re significantly higher than those of pregnant women who remained normotens ive. Microtransferrinuria as a predictor for pre-eclampsia had a sensitivit y 93.5%, specificity 65%, positive predictive value 83% and negative predic tive value 98.4%, whereas these values for microalbuminuria were: 50%, 58%, 50% and 91%, respectively. Urinary microtransferrin levels were significan tly elevated in women with elevated MAP and in women who delivered low birt h weight and low Apgar score babies. In conclusion, microtransferrinuria is a potentially more sensitive predictor of pre-eclampsia than microalbuminu ria. Moreover, microtransferrinuria in early pregnancy might be a negative marker of fetal outcome in pre-eclampsia.