{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T15:31:10Z","timestamp":1789831870688,"version":"4.0.1"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,12,27]],"date-time":"2023-12-27T00:00:00Z","timestamp":1703635200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To study the adverse maternal and perinatal outcomes in women with severe pre\u2010eclampsia (SPE) among different ranges of proteinuria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This prospective cohort study was conducted in Jawaharlal Institute of Postgraduate Medical Education and Research, India. After obtaining informed written consent, the 202 singleton women fulfilling the criteria of severe features of pre\u2010eclampsia were stratified based on the value of urine protein\u2010creatinine ratio (UPCR) as mild, moderate, severe, and massive proteinuria during pregnancy. Clinical outcomes were assessed and patients were followed up until 12\u2009weeks postpartum to identify persistent proteinuria and hypertension.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 202 women with SPE, adverse maternal outcomes were seen in 34.65% (<jats:italic>n<\/jats:italic>\u2009=\u200970) and adverse perinatal outcomes in 75.74% (<jats:italic>n<\/jats:italic>\u2009=\u2009153). The demographic and clinical factors were similar among women with increasing severity of proteinuria, except for mean systolic blood pressure, serum creatinine and total serum protein. UPCR was found to have a significant correlation with composite adverse perinatal outcome (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and individual outcomes of neonatal intensive care unit admission for &gt;48\u2009h (<jats:italic>P<\/jats:italic>\u2009=\u20090.01) and neonatal sepsis (<jats:italic>P<\/jats:italic>\u2009=\u20090.02) but not adverse maternal outcomes (<jats:italic>P<\/jats:italic>\u2009=\u20090.201). The optimum UPCR cutoff for adverse perinatal outcomes was 1.6 (sensitivity, 73.2%; specificity, 52.7%). In addition, 14.85% of the women had a persistently elevated UPCR and 3.96% had hypertension at 3\u2009months postpartum.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In women with SPE, severe and massive proteinuria were related to composite adverse perinatal outcome but not composite adverse maternal outcome. Moreover, antenatal 24\u2010h proteinuria was significantly associated with persistent proteinuria. Significant proteinuria in women with SPE poses a risk for chronic renal dysfunction, requiring follow\u2010up.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.15308","type":"journal-article","created":{"date-parts":[[2023,12,27]],"date-time":"2023-12-27T11:14:37Z","timestamp":1703675677000},"page":"1064-1071","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Proteinuria in predicting adverse outcomes in women with severe features of pre\u2010eclampsia from a developing country: A\u00a0prospective cohort study"],"prefix":"10.1002","volume":"165","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5836-7241","authenticated-orcid":false,"given":"Akshaya","family":"Murali","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Jawaharlal Institute of Postgraduate Medical Education and Research Puducherry India"},{"name":"Department of Obstetrics and Gynaecology St. Johns Medical College Hospital Bangalore India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sasirekha","family":"Rengaraj","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Jawaharlal Institute of Postgraduate Medical Education and Research Puducherry India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. S.","family":"Priyamvada","sequence":"additional","affiliation":[{"name":"Department of Nephrology Jawaharlal Institute of Postgraduate Medical Education and Research Puducherry India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sindhu","family":"Sivanandan","sequence":"additional","affiliation":[{"name":"Department of Neonatology Jawaharlal Institute of Postgraduate Medical Education and Research Puducherry India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karthik R.","family":"Udayakumar","sequence":"additional","affiliation":[{"name":"Department of Community Medicine Jawaharlal Institute of Postgraduate Medical Education and Research Puducherry India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,12,27]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003891"},{"issue":"3","key":"e_1_2_10_3_1","first-page":"283","article-title":"Racial\/ethnic differences in pregnancy\u2010related hypertensive disease in nulliparous women","volume":"24","author":"Ghosh G","year":"2015","journal-title":"Ethnicity & Disease"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.118.313276"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2004.00395.x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2018.05.004"},{"key":"e_1_2_10_7_1","first-page":"13","article-title":"Task force on hypertension in pregnancy, American College of Obstetricians and Gynecologists","author":"American College of Obstetricians and Gynecologists","year":"2013","journal-title":"Hypertens Pregnancy"},{"key":"e_1_2_10_8_1","first-page":"e1","article-title":"ACOG practice bulletin no. 202: gestational hypertension and preeclampsia","volume":"133","author":"Obstetricians ACo G","year":"2019","journal-title":"Obstet Gynecol"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-7-10"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2017.03.005"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2020.08.108"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.113.01115"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopha.2018.10.082"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/10641955.2019.1590718"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/10641955.2018.1487564"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.12487"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2019.03.033"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2003.84"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.5603\/GP.a2018.0044"},{"key":"e_1_2_10_20_1","doi-asserted-by":"crossref","DOI":"10.1177\/0300060520908114","article-title":"Association between proteinuria and maternal and neonatal outcomes in pre\u2010eclampsia pregnancy: a retrospective observational study","volume":"48","author":"Xu X","year":"2020","journal-title":"J Int Med Res"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.14017"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12958-021-00751-y"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.5468\/ogs.2017.60.3.260"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/431837"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2019.12.013"},{"issue":"3","key":"e_1_2_10_26_1","article-title":"Urinary protein\u2010to\u2010creatinine ratio: an indicator of adverse clinical outcomes in preeclampsia with proteinuria","volume":"14","author":"Chadha A","year":"2022","journal-title":"Cureus"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2009.12.036"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40620-019-00629-8"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/jch.12116"}],"container-title":["International Journal of Gynecology &amp; 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