The estriol/creatinine ratio in a random urine sample as a screening test

Area of Science:

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

Background:

• Intrauterine growth retardation (IUGR) and major fetal abnormalities pose significant risks to perinatal outcomes.
• Early detection of high-risk pregnancies is crucial for timely intervention and improved fetal survival rates.

Purpose of the Study:

• To evaluate the estriol/creatinine ratio in first-morning urine samples as a screening tool for identifying pregnancies at risk of adverse outcomes.
• To assess the correlation between the estriol/creatinine ratio and birthweight percentiles.

Main Methods:

• A cohort of 1808 pregnancies was studied at 32 weeks of gestation.
• The estriol/creatinine ratio was measured in first morning urine samples.
• Correlation with birthweight and perinatal mortality rates was analyzed.

Main Results:

• The estriol/creatinine ratio showed a close correlation with birthweight, increasing linearly with percentile birthweight groups.
• A ratio below the tenth percentile was associated with a 25-fold increase in perinatal mortality.
• All stillbirths with birthweight below the tenth percentile exhibited a low estriol/creatinine ratio.

Conclusions:

• The estriol/creatinine ratio is an effective, non-invasive method for early detection of pregnancies at high risk for IUGR or major abnormalities.
• This screening method can help identify pregnancies requiring closer monitoring and management, potentially reducing perinatal morbidity and mortality.