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PIERS proteinuria: relationship with adverse maternal and perinatal outcome.

Payne, B; Magee, LA; Côté, AM; Hutcheon, JA; Li, J; Kyle, PM; Menzies, JM; Moore, MP; Parker, C; Pullar, B; et al. Payne, B; Magee, LA; Côté, AM; Hutcheon, JA; Li, J; Kyle, PM; Menzies, JM; Moore, MP; Parker, C; Pullar, B; von Dadelszen, P; Walters, BN (2011) PIERS proteinuria: relationship with adverse maternal and perinatal outcome. Journal of Obstetrics and Gynaecology Canada, 33 (6). pp. 588-597. ISSN 1701-2163 https://doi.org/10.1016/S1701-2163(16)34907-6
SGUL Authors: von Dadelszen, Peter

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Abstract

OBJECTIVE: To examine the ability of three different proteinuria assessment methods (urinary dipstick, spot urine protein:creatinine ratio [Pr/Cr], and 24-hour urine collection) to predict adverse pregnancy outcomes. METHODS: We performed a prospective multicentre cohort study, PIERS (Preeclampsia Integrated Estimate of RiSk), in seven academic tertiary maternity centres practising expectant management of preeclampsia remote from term in Canada, New Zealand, and Australia. Eligible women were those admitted with preeclampsia who had at least one antenatal proteinuria assessment by urinary dipstick, spot urine Pr/Cr ratio, and/or 24-hour urine collection. Proteinuria assessment was done either visually at the bedside (by dipstick) or by hospital clinical laboratories for spot urine Pr/Cr and 24-hour urine collection. We calculated receiver operating characteristic area under the curve (95% CI) for each proteinuria method and each of the combined adverse maternal outcomes (within 48 hours) or adverse perinatal outcomes (at any time). Models with AUC ≥ 0.70 were considered of interest. Analyses were run for all women who had each type of proteinuria assessment and for a cohort of women ("ALL measures") who had all three proteinuria assessments. RESULTS: More women were proteinuric by urinary dipstick (≥ 2+, 61.4%) than by spot urine Pr/Cr (≥ 30 g/mol, 50.4%) or 24-hour urine collection (≥ 0.3g/d, 34.7%). Each proteinuria measure evaluated had some discriminative power, and dipstick proteinuria (categorical) performed as well as other methods. No single method was predictive of adverse perinatal outcome. CONCLUSION: The measured amount of proteinuria should not be used in isolation for decision-making in women with preeclampsia. Dipstick proteinuria performs as well as other methods of assessing proteinuria for prediction of adverse events.

Item Type: Article
Additional Information: © 2011 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved. Made available with permission from the publisher. Contact publisher for any further re-use.
Keywords: Adult, Cohort Studies, Creatinine, Female, Gestational Age, Humans, Pre-Eclampsia, Pregnancy, Pregnancy Outcome, Prospective Studies, Proteinuria, ROC Curve, Reagent Strips, Risk Factors, Urine Specimen Collection, Humans, Proteinuria, Pre-Eclampsia, Creatinine, Reagent Strips, Pregnancy Outcome, Risk Factors, Cohort Studies, Prospective Studies, ROC Curve, Gestational Age, Pregnancy, Adult, Female, Urine Specimen Collection, 1114 Paediatrics And Reproductive Medicine
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Journal of Obstetrics and Gynaecology Canada
ISSN: 1701-2163
Language: eng
Dates:
DateEvent
1 June 2011Published
Publisher License: Publisher's own licence
Projects:
Project IDFunderFunder ID
UNSPECIFIEDCanadian Institutes of Health ResearchUNSPECIFIED
PubMed ID: 21846448
Go to PubMed abstract
URI: http://openaccess.sgul.ac.uk/id/eprint/107534
Publisher's version: https://doi.org/10.1016/S1701-2163(16)34907-6

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