- Zahra Shahraki 1
- Khadije Rezaie Keikhaie 2
- Nooshin Amjadi 3
- Zohrehsadat Hashemi Bonjar 4
- Hosseinali Jahantigh 5
- Fatemeh Doosti 6
- Mahboobeh Shirazi 7
1 Asistent Professor of Infertility and IVF, Obstetric and Gynecology Department, Zabol University of Medical Sciences, Zabol, Iran
2 Asistent Professor of Maternal Fetal Medicine, Obstetric and Gynecology, Maternal and Fetal Health Research, Zabol University of Medical Sciences, Zabol, Iran
3 Prevention Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4 Phd Student in Health Service Management, MSC in Mother and Child Health Faculty Member of Zabol Medical University, Zabol, Iran
5 MD AP-CP, Pathoboiology Laboratory Director, Zabol University of Medical Sciences, Zabol, Iran
6 MD, Zabol University of Medical Sciences, Zabol, Iran
7 Maternal Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran
Background: Preeclampsia is one of the causes of maternal and prenatal mortality and morbidity. The 24-hour urine sample is considered as a gold standard for preeclampsia diagnosis and shortening the time of urine collection will result in the patients’ convenience and shorter hospitalization. The goal of this study was to determine thee diagnostic accuracy of 4 hour urine protein in comparison with 24 hour urine protein in pregnant women.
Methods: One hundred pregnant women, with a gestational age of more than 20 weeks, and were suspicious to preeclampsia were enrolled. The 24-hour as well as the 4-hour urine sample were collected. All data were analyzed using the SPSS software, version 20 (SPSS Inc., Chicago, IL, USA). The correlation coeﬃcient was used to determine relationship between the 4 and 24-hour urine proteins. receiver operating characteristic (ROC) curve was used to determine optimal cut-oﬀ values of 4 hour proteinuria.
Results: The mean age and mean gestational age of participants was 26.8 & 6.1 years and 34.1 & 3.4 weeks. The mean 4-hour urine protein was 165.6 & 170.2 mg and the mean 24 hour urine protein was 926 & 1013 mg. The mean age, 4-hour urine protein, and 4 as well as 24 hour urine volumes were signiﬁcantly diﬀerent between cases with no, mild, or severe proteinuria. Pearson correlation coeﬃcient between 4 and 24 hour proteinuria was strong (r = 0.97 and p < 0.001). The best cut oﬀ point for 4-hour proteinuria to determine proteinuria was 69.5 mg with a sensitivity of 93% and speciﬁcity of 100%. (Area under the curve = 0.99, p < 0.001).
Conclusions: Women that are suspicious to have preeclampsia, the total 4-hour urine protein values positively correlated with values of 24-hour samples.
- Alves JA, Silva BY, de Sousa PC, Maia SB, Costa Fda S. Reference range of uterine artery Doppler parameters between the 11th and 14th pregnancy weeks in a population sample from Northeast Brazil. Rev Bras Ginecol Obstet. 2013;35(8):357-62. [DOI:10.1590/S0100-72032013000800004] [PMID]
- Staﬀ AC, Dechend R, Pijnenborg R. Learning from the placenta: acute atherosis and vascular remodeling in preeclampsia-novel aspects for atherosclerosis and future cardiovascular health. Hypertension. 2010;56(6):1026-34. [DOI:10.1161/HYPERTENSIONAHA.110.157743] [PMID]
- Chan P, Brown M, Simpson JM, Davis G. Proteinuria in pre-eclampsia: how much matters? BJOG. 2005;112(3):280-5. [DOI:10.1111/j.1471-0528.2004.00395.x] [PMID]
- Jamal A, Abbasalizadeh F, Vafaei H, Marsoosi V, Eslamian L. Multi center screening for adverse pregnancy outcomes by uterine artery Doppler in the second and third trimester of pregnancy. Med Ultrason. 2013;15(2):95-100. [DOI:10.11152/mu.2013.2066.152.aj1fa2] [PMID]
- Brown MA, Buddie ML. The Importance of Nonproteinuric Hypertension in Pregnancy. Hypertens Pregnancy. 2009;14(1):57-65. [DOI:10.3109/10641959509058051]
- Brown MA, Lindheimer MD, de Swiet M, Van Assche A, Moutquin JM. The classiﬁcation and diagnosis of the hypertensive disorders of pregnancy: statement from the International Society for the Study of Hypertension in Pregnancy (ISSHP). Hypertens Pregnancy. 2001;20(1):IX-XIV. [DOI:10.3109/10641950109152635] [PMID]
- Adelberg AM, Miller J, Doerzbacher M, Lambers DS. Correlation of quantitative protein measurements in 8-, 12-, and 24-hour urine samples for the diagnosis of preeclampsia. Am J Obstet Gynecol. 2001;185(4):804-7. [DOI:10.1067/mob.2001.117302] [PMID]
- Chemicals SAF. Biochemicals and Reagents for Life Science Research. St Louis MO: Sigma-Aldrich; 2001.
- Amirai AGS, Yekta Z, Naji S, Danai S. Correlation betweeen 4 and 24 hour urine protein in pregnant women with gestational hypertension. Urmia Med J. 2010;21(1):10-6.
- Wongkitisophon K, Phupong V, Yamasmit W, Pansin P, Tannirandorn Y, Charoenvidhya D. Correlation of 4- and 24-hour urine protein in women with initially diagnosed hypertensive disorders in pregnancy. J Med Assoc Thai. 2003;86(6):529-34.