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

Abstract

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.