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 microtransferrinuria and microalbuminuria detected in pregnant women who are free of symptoms can predict the subsequent development of preeclampsia. One hundred fifty five pregnant women were successfully followed from 10 weeks gestation up till delivery. Pre-eclampsia developed in 31 women (17 mild and 12 severe pre-eclampsia), and eclampsia developed in two cases, whereas 124 women remained normotensive (controls). First morning urine specimens were collected during 10 to 12 weeks gestation and analyzed for microalbuminuria by a specific immunochemical test strip method. Mid-trimester mean arterial blood pressure (MAP) was also measured. Urinary microtransferrin levels in pregnant women who subsequently developed severe pre-eclampsia and eclampsia were significantly higher than those of pregnant women who remained normotensive. Microtransferrinuria as a predictor for pre-eclampsia had a sensitivity 93.5%, specificity 65%, positive predictive value 83% and negative predictive value 98.4%, whereas these values for microalbuminuria were: 50%, 58%, 50% and 91%, respectively. Urinary microtransferrin levels were significantly elevated in women with elevated MAP and in women who delivered low birth weight and low Apgar score babies. In conclusion, microtransferrinuria is a potentially more sensitive predictor of pre-eclampsia than microalbuminuria. Moreover, microtransferrinuria in early pregnancy might be a negative marker of fetal outcome in pre-eclampsia.