Abstract
(Acta Obstet Gynecol Scand. 2017;96(5):580–588) Preeclampsia can result in severe maternal complications and perinatal mortality. The albumin to creatinine ratio (ACR) is an independent prognostic factor for maternal and neonatal adverse outcomes in suspected preeclampsia. This retrospective cohort study aimed at determining the prognostic value of baseline first ACR in predicting maternal and neonatal adverse outcomes in women with suspected preeclampsia.
Highlights
The aim of this study was to determine the prognostic value of the first urinary albumin/creatinine ratio (ACR) for adverse maternal and neonatal outcomes and how it relates to other prognostic factors
The aim of this study was to examine the prognostic value of baseline ACR (ACR at first presentation) to predict maternal and neonatal adverse outcomes in women referred with suspected preeclampsia
Women were included if they had booked for their pregnancy prior to 14 weeks and if they were referred from primary care to the hospital Day Assessment Unit with suspected preeclampsia [suspected hypertension and at least 1+ proteinuria on dipstick testing]
Summary
The aim of this study was to determine the prognostic value of the first urinary albumin/creatinine ratio (ACR) for adverse maternal and neonatal outcomes and how it relates to other prognostic factors. Multivariate analysis of log-transformed ACR demonstrated that a 1-unit increase in log ACR is associated with an increased odds of adverse maternal [odds ratio 1.60, 95% confidence interval (CI) 1.45–1.80] and adverse neonatal (odds ratio 1.15, 95% CI 1.02–1.29) composite outcomes, and with reduced gestational age at delivery (coefficient: À0.46, 95% CI À0.54 to À0.38). ACR has been shown to be an accurate indicator of proteinuria in women with preeclampsia [4,5,6] Despite this evidence, the obstetric community has not widely adopted the use of ACR as yet, and protein to creatinine ratio or 24-h urine collection are more commonly employed
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