Should the spot albumin-to-creatinine ratio replace the spot protein-to-creatinine ratio as the primary screening tool for proteinuria in pregnancy?
| Autor: | Paul Champion de Crespigny, John R. Cade, Tien Nguyen, Thomas J. Cade, Mark P. Umstad |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
Urology Urinalysis Sensitivity and Specificity Severity of Illness Index Body Mass Index Preeclampsia Hospitals University chemistry.chemical_compound Pre-Eclampsia Predictive Value of Tests Pregnancy Internal Medicine medicine Albuminuria Humans Prospective Studies Prospective cohort study Gynecology Creatinine Proteinuria business.industry Body Weight Pregnancy Outcome Obstetrics and Gynecology medicine.disease chemistry Predictive value of tests Female Apgar score medicine.symptom business Biomarkers |
| Zdroj: | Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health. 5:298-302 |
| ISSN: | 2210-7789 |
| DOI: | 10.1016/j.preghy.2015.07.001 |
| Popis: | To determine the correlation between the spot albumin-to-creatinine (ACR) ratio and protein-to-creatinine ratio (PCR) in pregnancy and if either test is predictive of adverse pregnancy outcome.Prospective consecutive cohort study in a single tertiary centre examining 181 patients undergoing proteinuria screening after 20weeks of pregnancy. A spot PCR and ACR was performed on the first void of the day. Comparison was with linear and logistic regression and ROC curve. Optimal values for the ACR were obtained and compared to a PCR value of 30mg/mmol with respect to adverse pregnancy outcomes.Birth weight10th centile, preterm birth32 and37weeks, placental abruption, caesarean section, induction of labour, fetal death in utero or neonatal death, Apgar score5 at 1min and/or 5min, pulmonary oedema, sustained blood pressure170/110mmHg, magnesium infusion or labetalol infusion during labour.254 tests were performed. The ACR and PCR were highly correlated (r=0.95, p0.001) and the area under ROC curve was 0.98. An ACR of 13.4mg/mmol corresponded to a PCR of 30mg/mmol. Neither was more predictive of adverse pregnancy outcome nor was the level of proteinuria.The ACR is not inferior to nor does it perform better than the PCR in screening for proteinuria in pregnancy. Clinicians should use the test with which they are more familiar and may wish to assess local laboratory costs and methods in their selection. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect