Urinary microalbumin/creatinine ratios: reference range in uncomplicated pregnancy.
During uncomplicated pregnancy, the development of proteinuria is accepted as a poor prognostic sign and is associated with increasing maternal and perinatal mortality and morbidity. Physiological proteinuria increases with increasing gestation and one of its largest constituents is albumin. The reference range for the (micro)albumin/creatinine ratio (ACR) has not been described for normal pregnancy. This prospective cross-sectional study describes the gestation-specific 95% reference ranges for urinary microalbumin concentration, creatinine concentration and ACR in uncomplicated pregnancy. There is a significant increase ( P =0.016) in the ACR in the third trimester. The mean difference is 0.091 mg of albumin/mmol of creatinine (95% confidence interval, 0.014-0.168). Our results describe the first well-defined gestation-specific 95% reference range for a point-of-care measurement of the ACR. These data are essential if such testing is to be employed in antenatal care.
Waugh
Jason
J
Department of Obstetrics and Gynaecology, University of Leicester, Robert Kilpatrick Building, Leicester Royal Infirmary, Leicester LE2 7LX, UK. jason.waugh@uhl-tr.nhs.uk
Bell
Stephen C
SC
Kilby
Mark D
MD
Lambert
Paul C
PC
Blackwell
Claire N
CN
Shennan
Andrew
A
Halligan
Aidan
A
D000293:Adolescent; D000328:Adult; D000419:Albuminuria / Q000652:urine*; D003404:Creatinine / Q000652:urine*; D003430:Cross-Sectional Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy / Q000652:urine*; D011263:Pregnancy Trimester, Third / Q000652:urine; D011446:Prospective Studies; D012016:Reference Values
D003404:Creatinine