{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T03:33:20Z","timestamp":1790393600935,"version":"4.1.0"},"reference-count":22,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2014,3,31]]},"published-print":{"date-parts":[[2014,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Some women with isolated gestational proteinuria (IGP) later develop hypertension and are diagnosed with pre-eclampsia (PE). This study was performed to determine whether clinical features of such proteinuria preceding PE (P-PE) differ from those of other PE (O-PE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective observational study after approval of the institutional review board of ethics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A single university hospital. Proteinuria was defined as a protein-to-creatinine ratio (mg\/mg; P\/Cr) of \u22650.27 in the spot urine specimen. IGP was defined as proteinuria in the absence of hypertension. P-PE was defined as PE in which proteinuria preceded hypertension by more than 2\u2005days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>All of 10 and 18 consecutive women with P-PE and O-PE, respectively, who gave birth between January 2008 and August 2013.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Proteinuria appeared earlier (at 30.2\u00b13.0 vs 35.3\u00b14.3\u2005weeks, p=0.001), the P\/Cr level was greater at birth (7.28\u00b12.14 vs 3.19\u00b12.49, p&lt;0.001), net maternal weight gain during the last antenatal 1\u2005week was greater (3.1\u00b11.8 vs 1.3\u00b11.7\u2005kg, p=0.023) and length of pregnancy was shorter (32.5\u00b11.9 vs 36.1\u00b13.6\u2005weeks, p=0.001) in women with P-PE than in O-PE. The duration of IGP was 10.0\u00b15.9\u2005days (range 3\u201320), and the time interval until delivery after diagnosis of PE was 6.1\u00b18.2\u2005days (range 0\u201323) in 10 women with P-PE. The P\/Cr levels at birth were significantly inversely correlated with the antenatal lowest antithrombin activity and fibrinogen levels among the 28 women with PE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Women with P-PE were likely to exhibit greater proteinuria in the urine, greater water retention in the interstitial space and more enhanced coagulation\u2013fibrinolysis, thus suggesting that they may constitute a more severe form of PE than women with O-PE do.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2014-004870","type":"journal-article","created":{"date-parts":[[2014,4,19]],"date-time":"2014-04-19T21:07:37Z","timestamp":1397941657000},"page":"e004870","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Clinical features of isolated gestational proteinuria progressing to pre-eclampsia: retrospective observational study"],"prefix":"10.1136","volume":"4","author":[{"given":"Rina","family":"Akaishi","sequence":"first","affiliation":[{"name":"Department of Obstetrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Yamada","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mamoru","family":"Morikawa","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryutaro","family":"Nishida","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisanori","family":"Minakami","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2014,4,19]]},"reference":[{"key":"2025121602471635000_4.4.e004870.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60279-6"},{"key":"2025121602471635000_4.4.e004870.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68397-9"},{"key":"2025121602471635000_4.4.e004870.3","unstructured":"Kamiya K . Maternal and child health statistics of Japan. Tokyo: Japan Mothers\u2019 & Children's Health Organization, 2007 and 2012."},{"key":"2025121602471635000_4.4.e004870.4","first-page":"423","article-title":"Diagnosis of preeclampsia","volume":"65","author":"Chesley","year":"1985","journal-title":"Obstet Gynecol"},{"key":"2025121602471635000_4.4.e004870.5","doi-asserted-by":"publisher","DOI":"10.1515\/JPM.2008.062"},{"key":"2025121602471635000_4.4.e004870.6","doi-asserted-by":"crossref","first-page":"13","DOI":"10.4236\/ojog.2011.12003","article-title":"Isolated proteinuria as an initial sign of severe preeclampsia","volume":"1","author":"Yamada","year":"2011","journal-title":"Open J Obstet Gynecol"},{"key":"2025121602471635000_4.4.e004870.7","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1097\/GCO.0b013e32833040bf","article-title":"Outcome of pregnancy in patients with isolated proteinuria","volume":"21","author":"Morikawa","year":"2009","journal-title":"Curr Opin Obstet Gynecol"},{"key":"2025121602471635000_4.4.e004870.8","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0022115"},{"key":"2025121602471635000_4.4.e004870.9","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1111\/j.1471-0528.1998.tb09971.x","article-title":"Does gestational hypertension become pre-eclampsia?","volume":"105","author":"Saudan","year":"1998","journal-title":"Br J Obstet Gynaecol"},{"key":"2025121602471635000_4.4.e004870.10","unstructured":"National Institute for Clinical Excellence. Hypertension in pregnancy: the management of hypertensive disorders during pregnancy (clinical guideline 107). 2010. http:\/\/wwwniceorguk\/CG107.2010"},{"key":"2025121602471635000_4.4.e004870.11","doi-asserted-by":"crossref","first-page":"1174","DOI":"10.1111\/j.1447-0756.2011.01653.x","article-title":"Guidelines for obstetrical practice in Japan: Japan Society of Obstetrics and Gynecology (JSOG) and Japan Association of Obstetricians and Gynecologists (JAOG) 2011 edition","volume":"37","author":"Minakami","year":"2011","journal-title":"J Obstet Gynaecol Res"},{"key":"2025121602471635000_4.4.e004870.12","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.preghy.2013.01.009","article-title":"Clinical significance of proteinuria determined with dipstick test, edema, and weekly weight gain \u2265500 g at antenatal visit","volume":"3","author":"Chiba","year":"2013","journal-title":"Pregnancy Hypertens"},{"key":"2025121602471635000_4.4.e004870.13","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2008050493"},{"key":"2025121602471635000_4.4.e004870.14","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39532.543947.BE"},{"key":"2025121602471635000_4.4.e004870.15","doi-asserted-by":"crossref","first-page":"e76083","DOI":"10.1371\/journal.pone.0076083","article-title":"Association of proteinuria threshold in pre-eclampsia with maternal and perinatal outcomes: a nested case control cohort of high risk women","volume":"8","author":"Bramham","year":"2013","journal-title":"PLoS ONE"},{"key":"2025121602471635000_4.4.e004870.16","doi-asserted-by":"crossref","first-page":"381.e1","DOI":"10.1016\/j.ajog.2010.06.013","article-title":"Protein: creatinine ratio in uncomplicated twin pregnancy","volume":"203","author":"Smith","year":"2010","journal-title":"Am J Obstet Gynecol"},{"key":"2025121602471635000_4.4.e004870.17","first-page":"1","article-title":"Gestational weight gain according to number of fetuses in Japanese women","volume":"13","author":"Morikawa","year":"2013","journal-title":"J Perinat Med"},{"key":"2025121602471635000_4.4.e004870.18","doi-asserted-by":"crossref","first-page":"268","DOI":"10.3109\/10641955.2011.638957","article-title":"Risk factors of eclampsia other than hypertension: pregnancy-induced antithrombin deficiency and extraordinary weight gain","volume":"31","author":"Yamada","year":"2012","journal-title":"Hypertens Pregnancy"},{"key":"2025121602471635000_4.4.e004870.19","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/0002-9378(89)90096-3","article-title":"Enhanced thrombin generation in normal and hypertensive pregnancy","volume":"160","author":"de Boer","year":"1989","journal-title":"Am J Obstet Gynecol"},{"key":"2025121602471635000_4.4.e004870.20","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1111\/j.1471-0528.1993.tb15264.x","article-title":"Evaluation of six markers of the haemostatic system in normal pregnancy and pregnancy complicated by hypertension or pre-eclampsia","volume":"100","author":"Cadroy","year":"1993","journal-title":"Br J Obstet Gynaecol"},{"key":"2025121602471635000_4.4.e004870.21","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(98)70255-8"},{"key":"2025121602471635000_4.4.e004870.22","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318213cd31"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2014-004870","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T10:47:25Z","timestamp":1765882045000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2014-004870"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,4]]},"references-count":22,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2014,4,19]]},"published-print":{"date-parts":[[2014,4]]}},"alternative-id":["10.1136\/bmjopen-2014-004870"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2014-004870","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,4]]}}}