title: Second-trimester urine nephrin:creatinine ratio versus soluble fms-like tyrosine kinase-1:placental growth factor ratio for prediction of preeclampsia among asymptomatic women.
abstract: This prospective observational study compare urine nephrin:creatinine ratio (NCR, ng/mg) with serum soluble fms-like tyrosine kinase-1:placental growth factor ratio (FPR, pg/pg) for preeclampsia (PE) prediction among unselected asymptomatic pregnant women in 2ndtrimester. NCR and FPR were determined in 254 paired urine/blood samples collected simultaneously from 254 women at median gestational week (GW) 24 (range, 22-27) without hypertension or significant proteinuria in pregnancy (SPIP). Fifteen (5.9%) developed SPIP and hypertension at GW 34.0 (26.0-38.6) and 35.3 (27.6-38.6), respectively, and were diagnosed with PE at GW 35.7 (27.6-38.6). The 90thpercentile level determined in 239 women normotensive throughout pregnancy gave NCR (139) sensitivity and positive predictive values (PPV) of 60% (9/15) and 27% (9/33), while those for serum FPR (4.85) were 40% (6/15) and 20% (6/30), respectively. Relative risks (95%CI) of later PE were 10.0 (3.82-26.4; 27% [9/33] vs. 2.7% [6/221]) and 4.98 (1.91-13.0; 20% [6/30] vs. 4.0% [9/224]) for NCR-positive and FPR-positive women, respectively. Cut-offs suggested by ROC gave NCR (86.6) sensitivity and PPV of 87% (13/15) and 17% (13/79), and FPR (8.8) values of 40% (6/15) and 40% (6/15), respectively. Thus, 2ndtrimester NCR was superior to FPR for PE prediction.
authors.affiliation: Department of Obstetrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Tianyue
authors.initials: T
authors.lastname: Zhai
authors.affiliation: Department of Obstetrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Itsuko
authors.initials: I
authors.lastname: Furuta
authors.affiliation: Department of Obstetrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Kinuko
authors.initials: K
authors.lastname: Nakagawa
authors.affiliation: Department of Obstetrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kojima
authors.affiliation: Department of Obstetrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Umazume
authors.affiliation: Department of Obstetrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ishikawa
authors.affiliation: Department of Obstetrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yamada
authors.affiliation: Department of Obstetrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Mamoru
authors.initials: M
authors.lastname: Morikawa
authors.affiliation: Department of Obstetrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Hisanori
authors.initials: H
authors.lastname: Minakami
mesh_terms: D000328:Adult; D003404:Creatinine / Q000652:urine*; D003710:Demography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000652:urine; D008403:Mass Screening; D008565:Membrane Proteins / Q000652:urine*; D008875:Middle Aged; D000072483:Placenta Growth Factor / Q000652:urine*; D011225:Pre-Eclampsia / Q000175:diagnosis* / Q000652:urine*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second / Q000652:urine*; D011507:Proteinuria / Q000652:urine; D012995:Solubility; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000652:urine*; D055815:Young Adult
chemical_list: D008565:Membrane Proteins; C000608036:PGF protein, human; C113267:nephrin; D000072483:Placenta Growth Factor; D003404:Creatinine; D040281:Vascular Endothelial Growth Factor Receptor-1