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Abstract
Objective: To evaluate second trimester urinary electrolyte, microalbumin, and enzyme (N-acetyl-β-glucosaminidase) excretion as predictors of gestational hypertension and preeclampsia (PET), and to compare random with 24-h urine collections.
Subjects: 200 primagravid Chinese women who were normotensive at booking had measurements performed on both random and 24-h urine samples in the second trimester.
Outcome Measures: Development of nonproteinuric (gestational) hypertension or proteinuric hypertension (PET) during the antenatal period.
Conclusion: Urinary NAG/Cr ratio measured in 24-h or random urine collections in the second trimester of pregnancy is shown to have potential as a predictor of PET, outperforming Ca/Cr and albumin/Cr ratios.
A Comparison Of Second Trimester Urinary Electrolytes, Microalbumin, And N-Acetyl-β-Glucosaminidase For Prediction Of Gestational Hypertension And Preeclampsia
Results: Twenty-two pregnancies developed gestational hypertension and 8 PET. Twenty-four-hour (but not random) urine calcium/creatinine (Ca/Cr) ratios were significantly lower in patients who developed PET. The optimal cutoff value for Ca/Cr ratio for prediction of PET was equivalent to 0.3 mmol/mmol Cr at 22 weeks of gestation (Youden index = 0.39). Urine NAG/Cr ratios (both random and 24-h) were significantly higher in patients who developed antenatal PET than in normotensive pregnancies or those complicated by gestational hypertension. Twenty-four-hour urine albumin/Cr ratios were also higher in patients who subsequently developed PET. Receiver operating characteristic (ROC) curves show that NAG/Cr ratio is a better predictor of antenatal PET than Ca/Cr or albumin/Cr ratios. The optimal cutoff value for NAG/Cr ratio was between 50 and 55 U/mmol Cr at 22 weeks of gestation (Youden index = 0.52).