title: Urinary microalbumin/creatinine ratios: reference range in uncomplicated pregnancy.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Leicester, Robert Kilpatrick Building, Leicester Royal Infirmary, Leicester LE2 7LX, UK. jason.waugh@uhl-tr.nhs.uk
authors.forename: Jason
authors.initials: J
authors.lastname: Waugh
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Bell
authors.forename: Mark D
authors.initials: MD
authors.lastname: Kilby
authors.forename: Paul C
authors.initials: PC
authors.lastname: Lambert
authors.forename: Claire N
authors.initials: CN
authors.lastname: Blackwell
authors.forename: Andrew
authors.initials: A
authors.lastname: Shennan
authors.forename: Aidan
authors.initials: A
authors.lastname: Halligan
mesh_terms: 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
chemical_list: D003404:Creatinine