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Urinalysis vs urine protein–creatinine ratio to predict significant proteinuria in pregnancy

Journal of Perinatology volume 28, pages 461–467 (2008)Cite this article

Abstract

Objective: To compare the urine protein–creatinine ratio with urinalysis to predict significant proteinuria (⩾300 mg per day).

Study Design: A total of 116 paired spot urine samples and 24-h urine collections were obtained prospectively from women at risk for preeclampsia. Urine protein–creatinine ratio and urinalysis were compared to the 24-h urine collection.

Result: The urine protein–creatinine ratio had better discriminatory power than urinalysis: the receiver operating characteristic curve had a greater area under the curve, 0.89 (95% confidence interval (CI) 0.83 to 0.95) vs 0.71 (95% CI 0.64 to 0.77, P<0.001). When matched for clinically relevant specificity, urine protein–creatinine ratio (cutoff ⩾0.28) is more sensitive than urinalysis (cutoff ⩾1+): 66 vs 41%, P=0.001 (with 95 and 100% specificity, respectively). Furthermore, the urine protein–creatinine ratio predicted the absence or presence of proteinuria in 64% of patients; urinalysis predicted this in only 19%.

Conclusion: The urine protein–creatinine ratio is a better screening test. It provides early information for more patients.

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Acknowledgements

This study was financially supported by the Department of Gynecology and Obstetrics, Stanford University.

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Authors and Affiliations

  1. Division of Maternal Fetal Medicine, Department of Gynecology and Obstetrics, Stanford University, Stanford, CA, USA

    B K Dwyer & M Druzin

  2. Department of Family and Community Medicine, University of California, Davis, CA, USA

    M Gorman

  3. Division of Pain Medicine, Department of Anesthesiology, Stanford University, Stanford, CA, USA

    I R Carroll

Authors
  1. B K Dwyer
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  2. M Gorman
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  3. I R Carroll
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  4. M Druzin
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Correspondence to B K Dwyer.

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Dwyer, B., Gorman, M., Carroll, I. et al. Urinalysis vs urine protein–creatinine ratio to predict significant proteinuria in pregnancy. J Perinatol 28, 461–467 (2008). https://doi.org/10.1038/jp.2008.4

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