Preeclampsia Prediction through Mid-Trimester Spot UACR

A recent study aimed to assess the utility of spot urinary albumin/creatinine ratio (UACR)––measured between 17 and 24 weeks of gestation––in predicting the subsequent development of preeclampsia in asymptomatic pregnant women. 

This was a prospective observational study conducted over one year that included 81 participants with singleton pregnancies and no associated complications. 

The results indicated a significant difference in mean UACR between women who developed preeclampsia and those with gestational diabetes mellitus. Further, a notable association between severe preeclampsia, preeclampsia, and gestational diabetes with UACR was elicited at a 22 cutoff. Among those with UACR > 22, the adverse outcomes included – intrauterine fetal demise 2.5%; low birth weight – 12.5%; and neonatal intensive care unit admissions 7.5%. 

It was concluded that mid-trimester spot UACR measurement effectively predicts preeclampsia before its clinical manifestations, with a UACR >= 171 mg/g demonstrating high sensitivity (83.3%) and specificity (98.6%).

Source: Latha AP, Haripriya V, Ramya Raj P. The Journal of Obstetrics and Gynecology of India. 2023 Oct 31:1-6.