Urinary protein-to-creatinine ratio in pregnant women after dipstick testing: prospective observational study View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2015-12

AUTHORS

Yosuke Baba, Takahiro Yamada, Mana Obata-Yasuoka, Shun Yasuda, Yasumasa Ohno, Kosuke Kawabata, Shiori Minakawa, Chihiro Hirai, Hideto Kusaka, Nao Murabayashi, Yusuke Inde, Michikazu Nagura, Hiromi Hamada, Atsuo Itakura, Akihide Ohkuchi, Makoto Maeda, Norimasa Sagawa, Akihito Nakai, Soromon Kataoka, Keiya Fujimori, Yoshiki Kudo, Tomoaki Ikeda, Hisanori Minakami

ABSTRACT

BACKGROUND: The dipstick test is widely used as a primary screening test for detection of significant proteinuria in pregnancy (SPIP). However, it often shows a false positive test result. This study was performed to determine which pregnant women should be recommended to undergo determination of urinary protein-to-creatinine ratio (mg/mg, P/Cr test) after dipstick test for confirmation of SPIP. METHODS: This was a multicenter, prospective, and observational study of 2212 urine specimens from 1033 pregnant women who underwent simultaneous dipstick and P/Cr tests in the same spot urine samples at least once. SPIP was defined as P/Cr > 0.27. Preeclampsia was diagnosed in women with both hypertension and SPIP. RESULTS: Preeclampsia, hypertension alone, and SPIP alone developed in 202 (20 %), 73 (7.1 %), and 120 (12 %) women, respectively. Creatinine concentration [Cr] varied greatly, ranging from 8.1 to 831 mg/dL in the 2212 urine samples. Rate of positive dipstick test results increased with increasing [Cr], while SPIP prevalence rate was lower in urine samples with higher [Cr], yielding higher false positive rates in samples with higher [Cr]. Postpartum urine samples had significantly lower [Cr] compared to those obtained antepartum (60 [8.7-297] vs. 100 [10-401] mg/dL, respectively). At the first P/Cr test among women with similar dipstick test results, the risk of having SPIP was consistently and significantly higher for hypertensive women than for normotensive women at any dipstick test result: 18 % (14/77) vs. 3.2 % (8/251), 47 % (26/55) vs. 8.7 % (37/425), 91 % (82/90) vs. 59 % (44/75) for negative/equivocal, 1+, and ≥ 2+ test results, respectively. The risk of SPIP was 16 % (9/55) for normotensive women when two successive antenatal urine samples showed a dipstick test result of 1 + . CONCLUSIONS: For prediction of SPIP, the dipstick test was more likely to show a false positive result in concentrated urine samples with higher [Cr]. Hypertensive women with ≥ 1+ as well as normotensive women with ≥ 2+ on dipstick test should be advised to undergo the P/Cr test. More... »

PAGES

331

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12884-015-0776-9

DOI

http://dx.doi.org/10.1186/s12884-015-0776-9

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1032210932

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/26667089


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