Urinary Albumin to Creatinine Ratio as a Predictor of Preclampsia Among Pregnant Women at a Tertiary Care Hospital

Abstract

Objective:To determine the diagnostic accuracy of point urinary albumin to creatinine ratio at 20 +0 and 28 +0 weeks of gestation for predicting the possibility of developing pre-eclampsia, late in pregnancy. Study Design:A prospective cross sectional study. Place and Duration of Study: Gynecology Outpatients DepartmentMethodology: Age, weight, gravidity and Body Mass index was documented for total 250 patients included for study. Patients were divided on the basis of development of pre-eclampsia and their mean Albumin to creatinine ratio was compared by applying Student's t-test considering p≤0.05 statistically significant. Test positive and test negative patients were noted. The association of urinary albumin to creatinine ratio with pre-eclampsia was calculated. SPSS v.23 software was used to analyze the data. Results:Mean urinary albumin to creatinine ratio was 22.77±12.42 mg/mmol in normotensive women and 46.87±15.13 mg/mmol in pre-eclamptic women which was significantly higher in pre-eclamptic patients (p<0.001). The sensitivity of point urinary albumin to creatinine ratio at a cutoff value of 35.5mg/mmol is 73.91%; the specificity is 91.56%; the positive predictive value (PPV) is 72.34%; and negative predictive is 92.16%. Conclusion:Our study concluded that solitary point urinary albumin creatinine ratio values equal to or higher than 35.5mg/mmol, when quantified early during the second trimester had a higher specificity than the sensitivity and it can be safely used to rule out the possibility of developing pre-eclampsia, late in pregnancy.