Urinalysis or Urine Protein–Creatinine Ratio for Predicting Proteinuria During Pregnancy?

Significant proteinuria (≥300 mg/24 hours) after the 20th gestational week, in conjunction with elevated blood pressure, is diagnostic for preeclampsia. The gold standard for measuring proteinuria is 24-hour urine collection, but a faster screening method is needed. Accordingly, researchers evaluated both urine protein–creatinine ratio and dipstick urinalysis compared with 24-hour urine collection in 116 samples from 95 pregnant women; 41% of samples were from primigravidas.

At a cutoff of ≥0.15 (selected to maximize sensitivity), the urine protein–creatinine ratio had a sensitivity of 96% and a specificity of 53%. For dipstick urinalysis, sensitivity ranged from 11% to 41%, depending on the chosen cutoff. When cutoffs were selected such tha…