Background and Objectives: Hypertensive disorders are the most common medical complications of pregnancy with an incidence of 12-22% and are rampant globally. The aim of the study was to establish whether a spot urinary protein –creatinine ratio (UPCR) measured between 20-24 weeks of gestation can predict subsequent development of preeclampsia
Methods: The prospective observational study included 120 pregnant mothers with singleton pregnancy with normal renal function having no proteinuria, attending antenatal clinics between 20-24 weeks of gestational age in two tertiary care teaching hospitals. Spot UPCR test was done in a mid- stream urine sample and protein was estimated by immunoturbidimetric microalbumin method and creatinine by modified Jaffe’s method. Data was expressed as urine protein (mg/dl)/ urine creatinine (g/dl) = UPCR in mg/g or mg/mmol multiplying by 0.113.
Results: Prevalence of preeclampsia was 12.93%. The mean UPCR (mg//mmol) in unaffected group and preeclampsia groups was 26.84±4.69 and 44.12± 9.43 respectively. The optimal cut-off value of spot UPCR was considered 35.5 mg/mmol. The relative risk (RR) of developing preeclampsia in women with UPCR ≥35.5 mg/mmol was 21.78 (95% CI, 6.82- 69.54, p=0.0001). The sensitivity, specificity, PPV and NPV are of 80% and 94.06%, 66.67% and 96.94% respectively at or above UPCR cut-off value of 35.5 mg/mmol. The area under curve (AUC) of spot UPCR in ROC curve was 0.949 (95% CI, 0.891- 1.000).
Conclusions: A Spot UPCR ≥ 35.5 mg/mmol in the early part of mid trimester with high sensitivity and specificity is an accurate, reliable and steady fast time saving test that can predict the development of preeclampsia in later part of pregnancy.