Research Information System
Perinatal journal (Online), vol.31, no.1, pp.74-79, 2023 (Peer-Reviewed Journal)
Objective This study aimed to compare spot urine protein-to-creatinine ratio and 24-hour urine methods in pregnant patients and to evaluate the accuracy of spot urine protein-to-creatinine ratio against the reference standard 24-hour urine method. Methods This retrospective study included 399 pregnant patients diagnosed with proteinuria, gestational hypertension, or preeclampsia. Urinary protein concentrations were measured by spot dipstick urine analysis, spot urinary protein-to-creatinine, and 24-hour total proteinuria via 24-hour urine collection. The 24-hour total proteinuria measurement was accepted as the reference standard for diagnosis of proteinuria, and significant proteinuria was defined ≥300 mg of protein in the 24-hour urine collection. Results According to the receiver operating characteristics analysis of the spot urinary protein-to-creatinine ratio measurements, the cut-off value of the protein-to-creatinine ratio method was ≥0.443 mg protein/mg creatinine, the area under the curve was 0.887, the sensitivity was 77.14%, the specificity was 87.76%, and the accuracy was 84.96%. According to the receiver operating characteristics analysis of the 24-hour total proteinuria measurements, these values were >0.405 mg/day, 0.874, 82.86%, 84.64%, and 84.17%, respectively. No difference was observed between these two proteinuria methods regarding the receiver operating characteristics analysis (p=0.475). There was a strong and significant correlation between the spot urine protein-to-creatinine ratio and the 24-hour total proteinuria (r=0.842, p<0.001). Conclusion Our findings revealed that there was a strong and significant correlation between the spot urine protein-to-creatinine ratio and the 24-hour total proteinuria, and it may be used as an alternative to the 24-hour total proteinuria. In addition, the spot urine protein-to-creatinine ratio is noteworthy, especially in an emergency situation in pregnant women for whom the time is limited to make a rapid clinical decision.