title: Urine Protein/Creatinine Ratios during Labor: A Prospective Observational Study.
abstract: OBJECTIVE
  To evaluate the utility of urine protein/creatinine ratio (uPCR) measurements among healthy parturients at term we performed a prospective cohort study at a community teaching hospital.
  
  
  METHODS
  Serial urine samples were collected. Ninety-three women contributed 284 urine samples. uPCRs were determined. Multiple imputation and paired sampled analysis was performed when appropriate.
  
  
  RESULTS
  Two-thirds (63/93) of women had at least one measured uPCR ≥ 0.3. One-third (31/93) had a uPCR ≥ 0.3 at admission, including 39.1% (9/23) of women not in labor. Median (IQR) uPCRs increased during labor and after delivery: latent phase/no labor, 0.15 (0.06-0.32); active phase, 0.29 (0.10-0.58); early postpartum, 0.45 (0.18-1.36) (all p < 0.04). Median uPCRs were significantly < 0.3 in the latent phase and significantly > 0.3 in the immediate postpartum period (p < 0.01). Women who labored before cesarean delivery had the highest early postpartum uPCRs: median (IQR) 1.16 (0.39-1.80). A negative urine dipstick protein result did not exclude uPCR ≥ 0.3. uPCRs were similar when compared by method of urine collection.
  
  
  CONCLUSIONS
  uPCR ≥ 0.3 is common among healthy women with uncomplicated pregnancies at term. uPCR increases during labor and is not a reliable measure of pathologic proteinuria at term or during the peripartum period.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, Western Connecticut Health Network, Danbury, Connecticut, United States of America.
authors.forename: Vaya W
authors.initials: VW
authors.lastname: Tanamai
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, Western Connecticut Health Network, Danbury, Connecticut, United States of America.
authors.forename: Brandon-Luke L
authors.initials: BL
authors.lastname: Seagle
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, Western Connecticut Health Network, Danbury, Connecticut, United States of America.
authors.forename: Judy Y
authors.initials: JY
authors.lastname: Yeh
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, Western Connecticut Health Network, Danbury, Connecticut, United States of America.
authors.forename: Bethany
authors.initials: B
authors.lastname: Brady
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, Western Connecticut Health Network, Danbury, Connecticut, United States of America.
authors.forename: Corrie B
authors.initials: CB
authors.lastname: Miller
authors.affiliation: Department of Pathology and Laboratory Medicine, Western Connecticut Health Network, Danbury, Connecticut, United States of America.
authors.forename: Salvador
authors.initials: S
authors.lastname: Sena
authors.affiliation: Department of Pathology and Laboratory Medicine, Western Connecticut Health Network, Danbury, Connecticut, United States of America.
authors.forename: Jessica
authors.initials: J
authors.lastname: Dodge
authors.affiliation: Department of Obstetrics and Gynecology, Prentice Women's Hospital, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, United States of America.
authors.forename: Shohreh
authors.initials: S
authors.lastname: Shahabi
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, Western Connecticut Health Network, Danbury, Connecticut, United States of America.
authors.forename: Robert
authors.initials: R
authors.lastname: Samuelson
authors.affiliation: Department of Obstetrics & Gynecology, Tufts Medical Center, Boston, Massachusetts, United States of America.
authors.forename: Errol R
authors.initials: ER
authors.lastname: Norwitz
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, Western Connecticut Health Network, Danbury, Connecticut, United States of America.
authors.forename: Guoyang
authors.initials: G
authors.lastname: Luo
mesh_terms: D000328:Adult; D002585:Cesarean Section; D003404:Creatinine / Q000652:urine*; D003710:Demography; D005260:Female; D006760:Hospitalization; D006801:Humans; D007743:Labor, Obstetric; D049590:Postpartum Period; D011247:Pregnancy; D011446:Prospective Studies; D011506:Proteins / Q000032:analysis*; D011507:Proteinuria / Q000473:pathology / Q000652:urine; D055815:Young Adult
chemical_list: D011506:Proteins; D003404:Creatinine