ENHANCED URINARY ALBUMIN EXCRETION AFTER 35 WEEKS OF GESTATION AND DURING LABOR IN NORMAL-PREGNANCY

This study reports on the urinary albumin to creatinine ratio during normal pregnancy, with special emphasis on the pre-delivery and labour periods. Albumin was determined in single voided urine specimens obtained from healthy non-pregnant women (n=16) and healthy pregnant women (n=203; Groups A and B, 133 females examined during clinic visits and presentation at obstetric department; Group C, 70 females examined during labour) by radioimmunoassay (RIA). The mean ratio (+/-SD) for albumin/creatinine (A/Cr) in non-pregnant women was 1.46+/-0.32 mg mmol-1 Cr. Thus, 2.10 mg mmol-1 Cr (mean+2 SD) was considered to be the upper limit of normo-albuminuria. During pregnancy, 73% of the women (97 out of 133, Groups A and B) excreted less-than-or-equal-to 2.10 mg mmol-1 Cr. During the first 35 weeks of gestation, 30 of 34 pregnant women (88%) excreted less-than-or-equal-to 2.10 mg mmol-1 Cr, the mean being 0.93+/-0.64 mg mmol-1 Cr (median 1.0 mg mmol-1). During 36-42 weeks of gestation, the median A/Cr was 1.93 mg mmol-1 Cr (range 0.43-12.16) and 32 of 99 (32%) had values >2.10 mg mmol-1 Cr, an increase of more than two-fold (p<0.031) compared with the first 35 weeks. During labour, 61% of non-haematuric urines (33 of 54, Group C) were >2.10 mg mmol-1 Cr, being 125% greater (p<0.006) than that observed during pregnancy. Thus in normal pregnancy, A/Cr is increased during the late period of pregnancy and during labour.