Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Dec;73(Suppl 2):234-239.
doi: 10.1007/s13224-023-01862-9. Epub 2023 Oct 31.

Mid-Trimester Spot Urinary Albumin/Creatinine Ratio as a Screening Tool in Prediction of Pre-eclampsia

Akkenapally Prasanna Latha  1 , V Haripriya  1 , P Ramya Raj  1
Affiliations

Mid-Trimester Spot Urinary Albumin/Creatinine Ratio as a Screening Tool in Prediction of Pre-eclampsia

Akkenapally Prasanna Latha et al. J Obstet Gynaecol India. 2023 Dec.

Abstract

Aims and objectives: To determine utilization of spot urinary albumin/creatinine ratio (UACR) to predict subsequent development of preeclampsia, measured between 17 and 24 weeks of gestational age in asymptomatic antenatal woman and determine their maternal and neonatal outcomes.

Introduction: In preeclampsia the basic pathology is generalized endothelial dysfunction. It causes glomerular endotheliosis which leads to proteinuria, decreased glomerular filtration rate and renal blood flow. Thus microalbuminuria is an early marker which can measured to predict preeclampsia.

Materials and methods: It is a prospective observational study, carried out for one year in a cohort of asymptomatic antenatal women at 17-24 weeks of gestational age, attending hospital for routine antenatal check-up with a singleton pregnancy and no associated complications. Urine albumin and creatinine ratio (UACR) is measured at first visit, and women were followed till delivery and the maternal and foetal outcomes were recorded.

Results: Out of 81 pregnant women enrolled in the study, 58% belonged to 18-25 years, 54.3% belonged to lower middle class. There was a significant difference in mean UACR among women who developed preeclampsia (PE) and gestational diabetes mellitus (GDM) with p value < 0.05. In the study there was significant association between severe PE, PE and GDM with UACR at 22 as cut-off, with p value < 0.05. In the study among those with UACR > 22, 2.5% had IUFD, 12.5% had LBW, and 7.5% were admitted to NICU.

Conclusion: With the measurement of spot UACR in mid-trimester we can predict the development of preeclampsia before the onset of clinical manifestations. UACR > = 171 mg/g predicted preeclampsia well before the onset of clinical manifestations with high sensitivity of 83.3% and specificity of 98.6%.

Supplementary information: The online version contains supplementary material available at 10.1007/s13224-023-01862-9.

Keywords: Antenatal women; Gestational hypertension; Preeclampsia; Proteinuria; Spot urine albumin/creatinine ratio.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interestThe authors declare that there are no conflicts of interest for the present study.

Figures

Fig. 1
Fig. 1
Bar diagram showing UACR comparison with respect to maternal complications
Fig. 2
Fig. 2
ROC curve showing area under the ROC curve (AUC) for UACR in diagnosis of preeclampsia
See this image and copyright information in PMC

References

    1. Martin JN, Jr, My O, Keiser SD, et al. Standardized Mississippi protocol treatment of 190 patients with HELLP syndrome: slowing disease progression and preventing new major maternal morbidity. Hypertens Pregnancy. 2012;31(1):79–90. doi: 10.3109/10641955.2010.525277. - DOI - PubMed
    1. Roberts JM, Hubel CA. The two stage model of preeclampsia: variations on the theme. Placenta. 2009;30(Suppl. A):S32–S37. doi: 10.1016/j.placenta.2008.11.009. - DOI - PMC - PubMed
    1. Macdonald-Wallis C, Silberwood RJ, de Stavola BL, et al. Antenatal blood pressure for prediction of preeclampsia, preterm birth, and small for gestational age babies: development and validation in two general population cohorts. BMJ. 2015;351:h5948. doi: 10.1136/bmj.h5948. - DOI - PMC - PubMed
    1. Ohkuchi A, Hirashima C, Takahashi K, et al. Prediction and prevention of hypertensive disorders of pregnancy. Hypertens Res. 2017;40:5–14. doi: 10.1038/hr.2016.107. - DOI - PubMed
    1. Arias F, Daftary SN, Bhide AG, et al. Hypertensive Disorders in Pregnancy. In: Arias F, Bhide AG, Arulkumaran S, Damania K, Daftary SN, et al., editors. Practical guide to high risk pregnancy and delivery. A South Asian perspective. New Delhi: Elsevier India; 2015. pp. 185–230.

LinkOut - more resources