TOPLINE:

Women with preeclampsia and high levels of urinary protein excretion (UPE) had long-term higher risks for hypertension and chronic kidney disease (CKD) than women without preeclampsia. However, no significant association was observed between UPE level and the risk for cardiovascular disease (CVD).

METHODOLOGY:

• Researchers in Denmark conducted a population-based cohort study to evaluate whether UPE levels in women with preeclampsia were associated with long-term risks for new-onset maternal hypertension, CKD, and CVD.
• They included 286,078 women aged 15 years or older with pregnancies lasting at least 20 weeks between 1998 and 2018, using data from the Danish Medical Birth Register. The median follow-up duration was 6.4 years.
• Women with preeclampsia were categorised by the UPE level, using the highest measurement obtained between 20 weeks of pregnancy and 6 weeks postpartum. Women were classified as having no or mild UPE (urine albumin-creatinine ratio < 30 mg/g or a negative urine dipstick test) or moderate or severe UPE (urine albumin-creatinine ratio ≥ 30 mg/g or a positive urine dipstick test).
• The estimated 10- and 15-year risks for hypertension, CKD, and CVD were assessed by preeclampsia status and UPE level.

TAKEAWAY:

• Among all pregnant women, 3.3% developed preeclampsia. Of them, 58.3% had no or mild UPE and 41.7% had moderate or severe UPE.
• Women with preeclampsia and moderate or severe UPE had a higher estimated 10-year risk for hypertension than women without preeclampsia (16.0%; 95% CI, 14.6-17.5 vs 3.6%; 95% CI, 3.5-3.7). A similar trend was observed for the estimated 15-year risk (22.6%; 95% CI, 20.7-24.6 vs 7.2%; 95% CI, 7.0-7.3).
• The estimated 10-year risk for CKD was higher among women with preeclampsia and moderate or severe UPE than among those without preeclampsia (5.1%; 95% CI, 4.3-5.9 vs 0.4%; 95% CI, 0.4-0.5). A similar difference was observed at 15 years.
• No clear association between UPE level and the risk for CVD was observed among women with preeclampsia.

IN PRACTICE:

"Our findings highlight the need for structured postpartum follow-up for women with preeclampsia, particularly those with moderate/severe proteinuria," the authors wrote. 

"Incorporating proteinuria severity into postpartum risk stratification may help identify high-risk women and guide preventive strategies," they added.

SOURCE:

This study was led by Anne Høy Seemann Vestergaard, Aarhus University and Aarhus University Hospital, Aarhus, Denmark. It was published online on May 19, 2026, in BJOG: An International Journal of Obstetrics & Gynaecology.

LIMITATIONS:

The results of urine protein dipstick tests at consultations are not consistently recorded in laboratory databases in Denmark. In some Danish delivery wards, only urine protein dipstick testing is performed. Reliance on clinical laboratory data for the identification of CKD may have missed asymptomatic cases.

DISCLOSURES:

This study received funding from the European Research Council and Independent Research Fund Denmark. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.