| 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. |
| Rights: | http://creativecommons.org/licenses/by/4.0/ |
| Type: | article |
| URI: | http://hdl.handle.net/2115/60538 |
| 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)
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