Objective: To determine the accuracy of spot urine protein to creatinine ratio (uPCR) in predicting preeclampsia with severe features and adverse maternal or neonatal outcomes.

Materials and Methods: The present research was a retrospective study. Thai pregnant women with diagnosis of preeclampsia that delivered at Thammasat University Hospital in Thailand between January 2014 and August 2018 were included in the present study. The uPCR was collected and determined in the subjects who had hypertension or the presence of positive urine protein dipstick. Demographic characters and maternal and fetal outcomes were collected and evaluated.

Results: Four hundred cases of preeclampsia were recruited in the present study. There were 185 and 215 cases of severe preeclampsia (SPE) and mild preeclampsia (MPE) or without SPE features, respectively. Both groups showed comparable demographic characters. Mean uPCR of SPE and MPE cases were 4.4 and 1.0, respectively, with statistical difference. The optimal threshold of uPCR for diagnosing proteinuria in the present study was 1.0. Sensitivity, specificity, and positive and negative likelihood ratio (LR+ and LR–) were 57.84%, 80.47%, 2.92, and 0.52, respectively. Pregnant women who had high uPCR had more cesarean delivery rate and adverse obstetrics outcomes than those with low uPCR.

Conclusion: Spot urine sample for uPCR was a useful test for proteinuria instead of waiting for 24 hours urine protein collection. The uPCR equal or greater than 1.0 could predict hazardous maternal and neonatal outcomes for immediate pregnancy management.

Keywords: Pregnancy, Preeclampsia, Urine protein to creatinine ratio

Received 17 Jun 2019 | Revised 15 Aug 2019 | Accepted 16 Aug 2019