A point-of care urine test to predict preeclampsia development in Asian women with suspected preeclampsia

Wong, Sani T.K.; Sahota, Daljit Singh; Wong, Natalie K.; Wah, Isabella Y.M.; Wang, Xueqin; Lau, S.L.; Chiu, Chun-Jie; IP, Patricia N.P.; Poon, Liona C.

doi:10.1016/j.preghy.2023.03.003

Cited by 8 publications

(7 citation statements)

References 20 publications

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“…Among the 103 CRD test true-positives only one did not have proteinuria according to the 24-h urine determination. Wong et al 25 Compared with another Chinese study 24 screening for preeclampsia, the low sensitivity in our study might be related to the different patient characteristics and preeclampsia incidence in the study population.…”

Section: Discussioncontrasting

confidence: 62%

“…Among the 103 CRD test true‐positives only one did not have proteinuria according to the 24‐h urine determination. Wong et al 25 . illustrated the predictive detection rate of CRD test within 7, 14, and 28 days were 17.07%, 13.73%, and 10.61%, and the low sensitivity might due to the low proportion (23.8%) of proteinuria.…”

Section: Discussionmentioning

confidence: 99%

“…Two studies 24,25 in China investigate the screening performance of CRD test, in which preeclampsia was diagnosed on the day of sample collection or subsequently. Li et al 24 recruited hospitalized women, whose symptoms were mainly vaginal bleeding/discharge/abdominal pain, and pointed the detection rate of CRD test was 74%.…”

Section: Discussionmentioning

confidence: 99%

“…Two studies 24,25 in China investigate the screening performance of CRD test, in which preeclampsia was diagnosed on the day of sample collection or subsequently. Li et al 24 .…”

Section: Discussionmentioning

confidence: 99%

“…Wong et al. 25 illustrated the predictive detection rate of CRD test within 7, 14, and 28 days were 17.07%, 13.73%, and 10.61%, and the low sensitivity might due to the low proportion (23.8%) of proteinuria.…”

Section: Discussionmentioning

confidence: 99%

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Comparing urine point‐of‐care tests to screen preeclampsia: Congo‐red dot paper test versus dipstick urinalysis

Wang,

Gao,

Tang

et al. 2024

J of Clinical Hypertension

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To compare the urine Congo‐red dot paper test (CRD) with dipstick urinalysis to screen preeclampsia (PE). A total of 409 paired spot urine samples were obtained prospectively from women with suspected pre‐eclampsia attending for routine hospital visits. Congo‐red dot paper test and dipstick urinalysis were examined and compared to screen pre‐eclampsia. The agreement between the two urinary test is modest (kappa coefficient = 0.28, 95% CI 0.14–0.42). The specificity of CRD was higher than urinalysis (97.4% vs. 90.4%, p < .001). Urinalysis performed better in sensitivity (77.3% vs. 40.9%, p = .04) and the area under the receiver operating characteristic curves (AUC) (0.84 [95% CI 0.74–0.94] vs. 0.69 [95% CI 0.55–0.83], p = .04) than CRD, respectively. The sensitivity, specificity, AUC of the parallel test of them is 86.4% (64.0%–96.4%), 89.1% (85.5%–92.0%), and 0.88 (95% CI 0.79–0.96). And the serial test is 31.8% (14.7%–54.9%), 98.7% (96.8%–99.5%), 0.65 (95% CI 0.51–0.79), accordingly. The urinalysis is a better diagnosing test for preeclampsia. CRD could aid in the diagnosis of patients with preeclampsia. Combined the two tests in suspected patients may further improve the performance in the diagnosis of preeclampsia. Further study need to be made for its potential clinical practice.

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Section: Discussioncontrasting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Two studies 24,25 in China investigate the screening performance of CRD test, in which preeclampsia was diagnosed on the day of sample collection or subsequently. Li et al 24 .…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Comparing urine point‐of‐care tests to screen preeclampsia: Congo‐red dot paper test versus dipstick urinalysis

Wang,

Gao,

Tang

et al. 2024

J of Clinical Hypertension

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Intermanufacturer assessment of diagnostic performance of angiogenic ratio vs glycosylated fibronectin in women with suspected pre‐eclampsia

Wah,

Sahota,

Wong

et al. 2024

Ultrasound in Obstet & Gyne

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ObjectiveTo compare the diagnostic performance of different manufacturers' immunoassays for the soluble fms‐like tyrosine kinase‐1 (sFlt‐1)‐to‐placental growth factor (PlGF) ratio with that of a point‐of‐care test for glycosylated fibronectin (GlyFn) in women with suspected pre‐eclampsia (PE).MethodsThis was a prospective, single‐center, double‐blinded, non‐interventional study of East Asian women with a singleton pregnancy who presented with hypertension with or without clinical features of PE after 20 weeks' gestation between January 2020 and March 2022. Maternal serum samples were collected at the time of presentation, and subsequent management followed the departmental protocol, based on gestational age, severity of hypertension, fetal condition and presence of severe PE features. Women diagnosed with PE at presentation were excluded. PE was diagnosed according to the 2018 International Society for the Study of Hypertension in Pregnancy classification. Levels of sFlt‐1 and PlGF were measured using the Cobas e411 (Roche Diagnostics), BRAHMS KRYPTOR (ThermoFisher Scientific) and iMAGIN 1800 (Ningbo‐Aucheer) platforms. GlyFn levels were measured using the Lumella™ GlyFn PoC test (Diabetomics). The predictive performance of each test to rule out PE within 7 days and rule in PE within 28 days from the date of presentation was assessed. Based on the PROGNOSIS study, a sFlt‐1/PlGF ratio of ≤ 38 on the Roche platform was used to predict the absence of PE within 7 days. The sFlt‐1/PlGF ratio was classified as high or low using platform‐specific thresholds equivalent to a Roche sFlt‐1/PlGF ratio of 38, which were derived using Passing–Bablok regression. GlyFn was categorized as high or low using two reported clinical management thresholds (263 μg/mL and 510 μg/mL).ResultsOverall, 236 women with suspected PE were included, of whom 70 (29.7%) were diagnosed with PE; 36 (51.4%) and 70 (100%) developed PE within 7 days and 28 days, respectively. Eighty‐eight (37.3%) women had a sFlt‐1/PlGF ratio of > 38 on the Roche platform, 79 (33.5%) women had a sFlt‐1/PlGF ratio of > 55 on the KRYPTOR platform and 96 (40.7%) women had a sFlt‐1/PlGF ratio of > 40 on the iMAGIN 1800 platform. Furthermore, 62 (26.3%) and four (1.7%) women had a GlyFn level of > 263 μg/mL and > 510 μg/mL, respectively. The negative predictive value (NPV) of the sFlt‐1/PlGF ratio measured on the Roche, KRYPTOR and iMAGIN 1800 platforms to rule out PE within 7 days after presentation was 83.3%, 82.0% and 82.9%, respectively, while that for GlyFn > 263 μg/mL and > 510 μg/mL was 82.6% and 70.4%, respectively. The corresponding positive predictive values (PPV) to rule in PE within 28 days after presentation were 50.5%, 52.3% and 46.7%, respectively, for the sFlt‐1/PlGF ratio, and 35.4% and 50.0%, respectively, for GlyFn > 263 μg/mL and > 510 μg/mL.ConclusionsThe predictive performance of different manufacturers' assays for the sFlt‐1/PlGF ratio to rule in and rule out PE were similar once standardized to a common threshold. Our findings suggest that the sFlt‐1/PlGF ratio and GlyFn using a cut‐off of 263 μg/mL can both be utilized to rule out PE within 7 days after assessment, with a moderate NPV. The PPV for ruling in PE within 28 days remains poor. © 2024 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

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A point-of-care urine test to predict adverse maternal and neonatal outcomes in Asian women with suspected preeclampsia

Wong,

Wah,

Wong

et al. 2023

Arch Gynecol Obstet

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A point-of care urine test to predict preeclampsia development in Asian women with suspected preeclampsia

Cited by 8 publications

References 20 publications

Comparing urine point‐of‐care tests to screen preeclampsia: Congo‐red dot paper test versus dipstick urinalysis

Comparing urine point‐of‐care tests to screen preeclampsia: Congo‐red dot paper test versus dipstick urinalysis

Intermanufacturer assessment of diagnostic performance of angiogenic ratio vs glycosylated fibronectin in women with suspected pre‐eclampsia

A point-of-care urine test to predict adverse maternal and neonatal outcomes in Asian women with suspected preeclampsia

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