Microalbuminuria and the Hypertensive Disorders of Pregnancy

Microalbuminuria measurement is now widely available, but its use during and after pregnancy has not been clearly defined. This review will present a brief overview of microalbuminuria measurement and screening outside pregnancy, and discuss the diagnosis of microalbuminuria in pregnancy, the potential role of microalbuminuria in pregnancy for prediction and diagnosis of pre-eclampsia and for post partum assessment of long-term cardiovascular diseases. Several methods have been used in pregnancy for measurement of microalbuminuria. Screening is best performed by urinary spot albumin/creatinine ratio and cut-off values in the non-pregnant population are reasonable to be used in the first trimester. The roles of microalbuminuria screening in pregnancy remain unclear and further research is needed on the use of spot albumin/creatinine ratio for prediction and diagnosis of pre-eclampsia. Finally, the significance of persistent microalbuminuria beyond 6 weeks postpartum is also unclear. Microalbuminuria may represent generalized vascular disease or underlying renal disease. More research is needed into the natural history of microalbuminuria following hypertensive pregnancy, and any independent contribution of microalbuminuria to the heightened cardiovascular risk in these women.