Araştırma Makalesi

Proteinuria, Cerebrospinal Fluid Protein, and Perinatal Outcomes: A Prospective Controlled Study

Cilt: 36 Sayı: 2026 28 Ağustos 2026
PDF İndir
EN TR

Proteinuria, Cerebrospinal Fluid Protein, and Perinatal Outcomes: A Prospective Controlled Study

Öz

Aim: We compared cerebrospinal fluid (CSF) protein levels in pregnant women with and without proteinuria and evaluated the association of these parameters with maternal and neonatal outcomes.
Materials and Methods: This prospective controlled study enrolled 61 pregnant women scheduled for cesarean delivery under spinal anesthesia. Participants were allocated into two groups based on the presence or absence of proteinuria. Proteinuria was assessed through spot urine samples, whereas total protein was measured in CSF samples. Maternal demographic and obstetric data were recorded alongside neonatal outcomes.
Results: No significant correlation was identified between proteinuria and CSF protein levels 
(r = -0.014, p = 0.912). A spot urine protein-to-creatinine ratio cutoff of 1.26 predicted the need for neonatal intensive care unit (NICU) admission with a positive predictive value of 88.89% and a negative predictive value of 82.69%. The presence of spot proteinuria was associated with a 3.9-fold increased risk of fetal growth restriction (FGR) (p = 0.024), and urine protein values correlated significantly with the rate of NICU admission (r = 0.468, p = 0.001). Within the proteinuric group, the incidence of preeclampsia (23.3%, p = 0.004) and FGR (16.7%, p = 0.018) was significantly higher compared to controls. 
Conclusions: Although CSF protein levels did not correlate with proteinuria or perinatal outcomes, spot urine proteinuria is a significant predictor of preeclampsia, FGR, and the need for NICU admission. 

Anahtar Kelimeler

cerebrospinal fluid protein, fetal growth restriction, neonatal intensive care unit, preeclampsia, Proteinuria

Etik Beyan

This study was approved by the Necmettin Erbakan University Faculty of Medicine Research Ethics Committee with approval number 171, dated 03.03.2023.

Kaynakça

  1. 1. Burwick RM, Togioka BM, Speranza RJ, Gaffney JE, Roberts VHJ, Frias AE, et al. Assessment of blood-brain barrier integrity and neuroinflammation in preeclampsia. Am J Obstet Gynecol. 2019;221(3):269.e1-269.e8.
  2. 2. Steegers EA, von Dadelszen P, Duvekot JJ, Pijnenborg R. Pre-eclampsia. Lancet. 2010;376(9741):631-644.
  3. 3. Macdonald-Wallis C, Lawlor DA, Heron J, Fraser A, Nelson SM, Tilling K. Relationships of risk factors for pre-eclampsia with patterns of occurrence of isolated gestational proteinuria during normal term pregnancy. PLoS One. 2011;6(7):e22115.
  4. 4. Hutcheon JA, Lisonkova S, Joseph KS. Epidemiology of pre-eclampsia and the other hypertensive disorders of pregnancy. Best Pract Res Clin Obstet Gynaecol. 2011;25(4):391-403.
  5. 5. Fishel Bartal M, Lindheimer MD, Sibai BM. Proteinuria during pregnancy: definition, pathophysiology, methodology, and clinical significance. Am J Obstet Gynecol. 2022;226(2s):S819-S834.
  6. 6. Kamińska J, Dymicka-Piekarska V, Tomaszewska J, Matowicka-Karna J, Koper-Lenkiewicz OM. Diagnostic utility of protein to creatinine ratio (P/C ratio) in spot urine sample within routine clinical practice. Crit Rev Clin Lab Sci. 2020;57(5):345-364.
  7. 7. Cunningham FG, Leveno KJ, Bloom SL, Dashe JS, Hoffman BL, Casey BM, et al. Williams Obstetrics. 25th ed. New York: McGraw-Hill Education; 2018.
  8. 8. Czarniak N, Kamińska J, Matowicka-Karna J, Koper-Lenkiewicz OM. Cerebrospinal fluid-basic concepts review. Biomedicines. 2023;11(5):1461.
  9. 9. Hepnar D, Adam P, Žáková H, Krušina M, Kalvach P, Kasík J, et al. Recommendations for cerebrospinal fluid analysis. Folia Microbiol (Praha). 2019;64(3):443-452.
  10. 10. Ciampa E, Li Y, Dillon S, Lecarpentier E, Sorabella L, Libermann TA, et al. Cerebrospinal fluid protein changes in preeclampsia. Hypertension. 2018;72(1):219-226.

Kaynak Göster

APA
Erdoğan, A. C., Akkuş, F., Ezveci, H., Reisli, R., & Gezginç, K. (2026). Proteinuria, Cerebrospinal Fluid Protein, and Perinatal Outcomes: A Prospective Controlled Study. Genel Tıp Dergisi, 36(2026), 1-6. https://doi.org/10.54005/geneltip.1826427
AMA
1.Erdoğan AC, Akkuş F, Ezveci H, Reisli R, Gezginç K. Proteinuria, Cerebrospinal Fluid Protein, and Perinatal Outcomes: A Prospective Controlled Study. Genel Tıp Derg. 2026;36(2026):1-6. doi:10.54005/geneltip.1826427
Chicago
Erdoğan, Arif Caner, Fatih Akkuş, Huriye Ezveci, Ruhiye Reisli, ve Kazım Gezginç. 2026. “Proteinuria, Cerebrospinal Fluid Protein, and Perinatal Outcomes: A Prospective Controlled Study”. Genel Tıp Dergisi 36 (2026): 1-6. https://doi.org/10.54005/geneltip.1826427.
EndNote
Erdoğan AC, Akkuş F, Ezveci H, Reisli R, Gezginç K (01 Ağustos 2026) Proteinuria, Cerebrospinal Fluid Protein, and Perinatal Outcomes: A Prospective Controlled Study. Genel Tıp Dergisi 36 2026 1–6.
IEEE
[1]A. C. Erdoğan, F. Akkuş, H. Ezveci, R. Reisli, ve K. Gezginç, “Proteinuria, Cerebrospinal Fluid Protein, and Perinatal Outcomes: A Prospective Controlled Study”, Genel Tıp Derg, c. 36, sy 2026, ss. 1–6, Ağu. 2026, doi: 10.54005/geneltip.1826427.
ISNAD
Erdoğan, Arif Caner - Akkuş, Fatih - Ezveci, Huriye - Reisli, Ruhiye - Gezginç, Kazım. “Proteinuria, Cerebrospinal Fluid Protein, and Perinatal Outcomes: A Prospective Controlled Study”. Genel Tıp Dergisi 36/2026 (01 Ağustos 2026): 1-6. https://doi.org/10.54005/geneltip.1826427.
JAMA
1.Erdoğan AC, Akkuş F, Ezveci H, Reisli R, Gezginç K. Proteinuria, Cerebrospinal Fluid Protein, and Perinatal Outcomes: A Prospective Controlled Study. Genel Tıp Derg. 2026;36:1–6.
MLA
Erdoğan, Arif Caner, vd. “Proteinuria, Cerebrospinal Fluid Protein, and Perinatal Outcomes: A Prospective Controlled Study”. Genel Tıp Dergisi, c. 36, sy 2026, Ağustos 2026, ss. 1-6, doi:10.54005/geneltip.1826427.
Vancouver
1.Arif Caner Erdoğan, Fatih Akkuş, Huriye Ezveci, Ruhiye Reisli, Kazım Gezginç. Proteinuria, Cerebrospinal Fluid Protein, and Perinatal Outcomes: A Prospective Controlled Study. Genel Tıp Derg. 01 Ağustos 2026;36(2026):1-6. doi:10.54005/geneltip.1826427