Abstract
Objective
To estimate the gestational age-specific serum creatinine (sCr) in
pregnancy.
Design
A population-based prospective cohort study.
Settings
Anuradhapura district, Sri Lanka
Population or sample
Study group: Healthy pregnant women with a period of gestation less than
12 weeks and without pre-existing medical conditions. Comparison group:
A sample of non-pregnant reproductive age females from a
population-based renal screening.
Methods
Baseline data were compared among pregnant and non-pregnant groups and
the pregnant women were followed-up until the end of the second
trimester.
Main Outcome Measures
Gestational period-specific sCr.
Results
A total of 2,259 pregnant women and 2.012 non-pregnant women were
recruited. The mean (SD) sCr of the 2,012 nonpregnant women was
62.8(12.4) μmol/L, with the 97.5th percentile of 89.0 μmol/L. The mean
(SD) eGFR was 105.1(27.9) mL/min/1.73 m2. At 4-7, 8-9, 10-12, 24-27 and
28-30 weeks of pregnancy, the mean sCr was 55.1, 52.7, 51.0, 47.2, and
49.3, while the 97.5th percentile for sCr was 72.4, 69.2, 69.3, 63.9,
and 66.0 μmol/L, respectively, in the sample of pregnant women. In the
first and second trimesters, the average sCr value was 84.7% and 76.4%
of that of the nonpregnant group, respectively. The mean eGFR increased
up to 129.4 mL/min/1.73 m2 in the 24th week of gestation. The analysis
of cohort data clearly confirmed a significant reduction in sCr with
advancing pregnancy (p<0 .001).
Conclusions
This study confirms that the precise normative data needs to be
considered in the interpretation of sCr in pregnancy, based on the
period of gestation.
Key words : renal functions, pregnancy, serum creatinine,
threshold,