Comparison of the Predictive Value of Urinary Calcium to Creatinine Ratio, Roll –over Test and BMI in Early Diagnosis of Preeclampsia.

Abstract

Abstract: Introduction: Preeclampsia is a common complication of pregnancy and it is a major cause of maternal and perinatal morbidity and mortality. But predicting of preeclampsia would allow better counseling. Several biophysical and biochemical parameters have been investigated for early detection of PE; however, none of them has the accuracy and reproducibility necessary to predictive of PE. The purpose of this study was to develop a predictive model for preeclampsia. This study was performed at health centers of Tabriz in 1386. Material and Method: This was a descriptive –analytically study that data collected with a randomly sampling of 400 nulliparous women between the 28 and 32 weeks of gestation. At first, weight, height, blood pressure on left position and supine position was measured and sample of urine was cached for calcium and creatinine measuring. This women were followed until delivery. Results: Of total 400 women 23 women developed preeclampsia. Mean urinary calcium to creatinine ratio in preeclampsia women (0.106±0.077 mg/dl) was lower than normotensive women (0.155±0.084 mg/dl) (p<0.05). Using the ROC, urinary calcium to creatinine ratio lower than 0.063 shows a sensitivity 35%, specificity 93%, positive and negative values 24% and 96% respectively. Mean difference of diastolic blood pressure in left position and diastolic blood pressure in supine position in preeclampsia women (15±9 mmHg) was higher than normotensive women (5.2±8.2 mmHg) (p<0.05). When Roll –over test was higher than 20 mmHg shows a sensitivity 52%, specificity 95%, positive and negative value 39% and 97%. Also mean BMI in preeclampsia women (29.93±4.20) was higher than normotensive women (26.24±2.72) (p<0.05). Using the ROC, BMI higher than 28.88 shows a sensitivity 61%, specify 92%, positive and negative values 33% and 97%. Also when three test were positive, they had sensitivity of 17%, specificity of 99.5%, positive and negative values of 67% and 95.2% respectively. Conclusion: Although no single test is fully predictive preeclampsia but the combination of three test has low sensitivity however it has high specificity for refusing of preeclampsia.