Sympathetic Overactivity Predicts Microalbuminuria in Pregnancy
Published: December 1, 2018 | DOI: https://doi.org/10.7860/JCDR/2018/36738.12412
Inder Pal Kaur, Sukanya Gangopadhyay, Kiran Singh, Mamta Tyagi, Gautam Sarkar
1. Senior Resident, Department of Biochemistry, Paras Hospital, Gurugram, NCR Delhi, India.
2. Assistant Professor, Department of Biochemistry, VMMC and Safdarjung Hospital, New Delhi, India.
3. Professor and Head, Department of Physiology, Subharti Medical College, Meerut, Uttar Pradesh, India.
4. Professor, Department of Obstetrics and Gynecology, Subharti Medical College, Meerut, Uttar Pradesh, India.
5. Professor and Head, Department of Biochemistry, Andaman and Nicobar Islands Medical College, Port Blair, Andaman and Nicobar Islands, India.
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.
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