Sympathetic Overactivity Predicts Microalbuminuria in Pregnancy
BC08-BC12
Correspondence
Dr. Sukanya Gangopadhyay,
Room 218, VMMC, Safdarjung Hospital, New Delhi-110029, India.
E-mail: sukanya.gangopadhyay@gmail.com
Introduction: Microalbuminuria is a frequent feature in pregnancy, as the latter is a state of haemodynamic changes and sympathetic overactivity. Both sympathetic overactivity {as measured by Heart Rate Variability (HRV)} and microalbuminuria are individually linked with hypertension. So, presence of these conditions in pregnant women could be the reason for the increasing prevalence of Pregnancy Induced Hypertension (PIH)/Preeclampsia.
Aim: To measure HRV and urinary microalbumin excretion simultaneously in pregnant women.
Materials and Methods: In this hospital-based study, pregnant women in 2nd and 3rd trimester were recruited along with age-matched controls. Their sympathetic activity and urinary albumin-creatinine ratio were recorded. The patients were followed till delivery to note progression to preeclampsia/ pregnancy-induced hypertension. Statistical analysis was done with appropriate tests using Graphpad Prizm (version 7.04).
Results: The level of urinary microalbumin was found to be high in the pregnant group. Albumin Creatinine Ratio (ACR) was raised in pregnancy (72.35±50.29 in third trimester, 84.48±52.61 in second trimester and 17.59±6.19 in non-pregnant control group; p<0.001). The HRV study shows that sympathetic dominance is more during pregnancy as compared to non-pregnant (2.09±0.91 in pregnant and 1.04±0.65 in non-pregnant group).
Conclusion: It was concluded that there is a neurogenic role for the causation of microalbuminuria in pregnancy. As this condition predicts the development of pre-eclampsia/eclampsia in later pregnancy, all the methods targeting generalised stress reduction could be advised to all pregnant women during their first visit.