The Utility of 12-Hour Urine Collection for the Diagnosis of Preeclampsia: A Systematic Review and Meta-analysis.
OBJECTIVE
To systematically review the literature and synthesize data on the diagnostic performance of a 12-hour urine collection for proteinuria in pregnant women with suspected preeclampsia.


METHODS
We performed a literature search of PubMed, Embase, Scopus, ClinicalTrials.gov, and CINAHL through February 2014 using key words related to gestational hypertension, preeclampsia, and proteinuria.


METHODS
Studies that contained results of both the 12-hour and 24-hour urine collection in the same patients were eligible.


RESULTS
Three independent reviewers abstracted test performance characteristics from each study for the performance of a 12-hour urine collection for the diagnosis of proteinuria defined as 300 mg in 24 hours. Diagnostic meta-analysis was performed to obtain summary statistics. Heterogeneity was assessed using the Cochrane Q or I. Receiver operating characteristic curve analysis was used to assess the optimal diagnostic cutpoint for proteinuria from a 12-hour urine collection. Stratified analysis was performed based on whether patients were on bed rest during urine collection. A total of seven studies met inclusion criteria. The 12-hour urine protein was overall highly predictive of proteinuria on 24-hour urine collection area under receiver operating characteristic curve: 0.97 (95% confidence interval [CI] 0.95-0.98). The pooled sensitivity was 92% (95% CI 86-96) and specificity was 99% (95% CI 75-100). The optimal cutpoint based on the receiver operating characteristic curve was 150 mg of protein on 12-hour collection.


CONCLUSIONS
A 12-hour urine collection compares favorably with a 24-hour urine collection for the diagnosis of proteinuria in women with suspected preeclampsia and has the advantage of convenience and improved clinical efficiency.
Departments of Obstetrics and Gynecology and Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri.
Molly J
MJ
Stout
Shayna N
SN
Conner
Graham A
GA
Colditz
George A
GA
Macones
Methodius G
MG
Tuuli
D005260:Female; D006801:Humans; D011225:Pre-Eclampsia / Q000175:diagnosis* / Q000652:urine; D011247:Pregnancy; D011507:Proteinuria / Q000175:diagnosis* / Q000652:urine; D059349:Urine Specimen Collection / Q000592:standards*