Comparison of proteinuria assessment methods and their association with maternal-fetal outcomes in preeclampsia

Area of Science:

• Obstetrics and Gynecology
• Clinical Chemistry
• Maternal-Fetal Medicine

Background:

• Preeclampsia is a serious pregnancy disorder marked by hypertension and proteinuria.
• Early detection of proteinuria is vital for managing maternal and fetal health.
• The 24-hour urine protein test is the current standard for proteinuria assessment.

Purpose of the Study:

• To compare proteinuria assessment using dipstick and urine protein-to-creatinine ratio (UPCR) against the 24-hour urine protein test in preeclampsia patients.
• To evaluate the diagnostic accuracy of UPCR as a rapid alternative to the 24-hour urine protein test.

Main Methods:

• Prospective analytical study conducted over 18 months in Indian tertiary care centers.
• Inclusion of pregnant women with preeclampsia after 20 weeks of gestation.
• Comparison of dipstick test and UPCR results with the gold standard 24-hour urine protein test.

Main Results:

• A significant positive linear relationship was found between UPCR and 24-hour urine protein levels.
• Adverse maternal and fetal outcomes were more frequent with UPCR > 0.3, particularly in severe preeclampsia.
• The optimal UPCR cut-off for predicting >300 mg/dL of 24-hour proteinuria was 1.29, with 100% sensitivity and 58.2% specificity.

Conclusions:

• The spot urine protein-to-creatinine ratio (UPCR) is a quick, accurate, sensitive, and specific method for proteinuria assessment in preeclampsia.
• UPCR demonstrates a strong correlation with the 24-hour urine protein test.
• A UPCR cut-off of 1.29 is proposed for identifying significant proteinuria in preeclampsia.