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

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Title: Urinary protein-to-creatinine ratio in pregnant women after dipstick testing : prospective observational study
Authors: Baba, Yosuke Browse this author
Yamada, Takahiro Browse this author →KAKEN DB
Obata-Yasuoka, Mana Browse this author →KAKEN DB
Yasuda, Shun Browse this author
Ohno, Yasumasa Browse this author
Kawabata, Kosuke Browse this author
Minakawa, Shiori Browse this author
Hirai, Chihiro Browse this author
Kusaka, Hideto Browse this author →KAKEN DB
Murabayashi, Nao Browse this author →KAKEN DB
Inde, Yusuke Browse this author
Nagura, Michikazu Browse this author
Hamada, Hiromi Browse this author
Itakura, Atsuo Browse this author →KAKEN DB
Ohkuchi, Akihide Browse this author →KAKEN DB
Maeda, Makoto Browse this author
Sagawa, Norimasa Browse this author →KAKEN DB
Nakai, Akihito Browse this author →KAKEN DB
Kataoka, Soromon Browse this author
Fujimori, Keiya Browse this author →KAKEN DB
Kudo, Yoshiki Browse this author →KAKEN DB
Ikeda, Tomoaki Browse this author →KAKEN DB
Minakami, Hisanori Browse this author →KAKEN DB
Keywords: Gestational hypertension
Kidney function
Preeclampsia prediction
Protein creatinine ratio
Proteinuria pregnancy
Urine dipstick
Issue Date: 14-Dec-2015
Publisher: BioMed Central
Journal Title: BMC Pregnancy and Childbirth
Volume: 15
Start Page: 331
Publisher DOI: 10.1186/s12884-015-0776-9
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.
Type: article
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 山田 崇弘

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