Gestational period-specific renal functions: Evidence from a large,
community-based, prospective cohort in rural Sri Lanka
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.