The importance of second-trimester AFP and preconception TSH levels for predicting the severity of proteinuria in patients with preeclampsia

Year 2024, Volume: 2 Issue: 1, 11 - 19, 29.01.2024

Nefise Nazlı Yenigül , Fedi Ercan , Emre Başer , Elif Yuce Bilgin , Serpil Kırım Neslihan Bahat

https://doi.org/10.61678/bursamed.1394794

Abstract

Objective: This study aimed to investigate the relationships between preconception thyroid stimulating hormone (TSH) and thyroxine (T4) levels, as well as second-trimester alpha-fetoprotein (AFP) levels, and the severity of proteinuria in 24-hour urine samples from patients with preeclampsia.
Method: This retrospective analysis focused on preeclampsia patients categorized by proteinuria in 24-hour urine. Inclusion criteria involved patients aged 20-44 with singleton pregnancies diagnosed with preeclampsia and delivery after 20 weeks of gestation. Patients were divided into mild (0.3 to <2 g, n = 94), severe (2 to <5 g, n = 38), and massive (≥5 g, n = 11) proteinuria groups. Comparison included second-trimester AFP levels, preconception TSH, and maternal/neonatal outcomes.
Results: Second-trimester AFP levels increased with proteinuria severity (mild: 47.97 ng/ml; severe: 60.52 ng/ml; massive: 65.50 ng/ml [p<0.001]). AFP emerged as a significant independent predictor of severe proteinuria (odds ratio=1.041), while TSH was not predictive (odds ratio=1.098; p=0.463).
Conclusion: AFP proved to be a valuable marker for predicting proteinuria severity in 24-hour urine samples from preeclampsia patients, whereas preconception TSH was a less compelling predictor.

Keywords

AFP, TSH, preeclampsia, proteinuria, pregnancy

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