PIERS proteinuria: relationship with adverse maternal and perinatal outcome - PubMed (original) (raw)

Comparative Study

. 2011 Jun;33(6):588-597.

doi: 10.1016/S1701-2163(16)34907-6.

Laura A Magee 2, Anne-Marie Côté 3, Jennifer A Hutcheon 4, Jing Li 1, Phillipa M Kyle 5, Jennifer M Menzies 1, M Peter Moore 6, Claire Parker 7, Barbra Pullar 5, Peter von Dadelszen 4, Barry N Walters 8; PIERS Study Group (Appendix); P von Dadelszen 9, L A Magee 9, M J Douglas 9, K R Walley 9, J A Russell 9, S K Lee 9, A Gruslin 9, G N Smith 9, A M Côté 9, J-M Moutquin 9, M A Brown 10, G Davis 10, B N Walters 10, N Sass 11, T Duan 12, J Zhou 12, S Mahajan 13, A Noovao 13, L A McCowan 14, P Kyle 14, M P Moore 14, S Z Bhutta 15, Z A Bhutta 15, Hall 16, D W Steyn 16, F Broughton Pipkin 17, P Loughna 17, S Robson 17, M de Swiet 17, J J Walker 17, W A Grobman 18, M D Lindheimer 18, J M Roberts 18, J Mark Ansermino 19, Samantha Benton 19, Geoff Cundiff 19, Dany Hugo 19, K S Joseph 19, Sayrin Lalji 19, Jing Li 19, Paula Lott 19, Annie B Ouellet 19, Dorothy Shaw 19, D Keith Still 9, George Tawagi 9, Brenda Wagner 9, Christine Biryabarema 20, Florence Mirembe 20, Annettee Nakimuli 20, Eleni Tsigas 21, Mario Merialdi 22, Mariana Widmer 22

Affiliations

Comparative Study

PIERS proteinuria: relationship with adverse maternal and perinatal outcome

Beth Payne et al. J Obstet Gynaecol Can. 2011 Jun.

Abstract

Objective: To examine the ability of three different proteinuria assessment methods (urinary dipstick, spot urine protein:creatinine ratio [Pr/Cr], and 24-hour urine collection) to predict adverse pregnancy outcomes.

Methods: We performed a prospective multicentre cohort study, PIERS (Preeclampsia Integrated Estimate of RiSk), in seven academic tertiary maternity centres practising expectant management of preeclampsia remote from term in Canada, New Zealand, and Australia. Eligible women were those admitted with preeclampsia who had at least one antenatal proteinuria assessment by urinary dipstick, spot urine Pr/Cr ratio, and/or 24-hour urine collection. Proteinuria assessment was done either visually at the bedside (by dipstick) or by hospital clinical laboratories for spot urine Pr/Cr and 24-hour urine collection. We calculated receiver operating characteristic area under the curve (95% CI) for each proteinuria method and each of the combined adverse maternal outcomes (within 48 hours) or adverse perinatal outcomes (at any time). Models with AUC ≥ 0.70 were considered of interest. Analyses were run for all women who had each type of proteinuria assessment and for a cohort of women ("ALL measures") who had all three proteinuria assessments.

Results: More women were proteinuric by urinary dipstick (≥ 2+, 61.4%) than by spot urine Pr/Cr (≥ 30 g/mol, 50.4%) or 24-hour urine collection (≥ 0.3g/d, 34.7%). Each proteinuria measure evaluated had some discriminative power, and dipstick proteinuria (categorical) performed as well as other methods. No single method was predictive of adverse perinatal outcome.

Conclusion: The measured amount of proteinuria should not be used in isolation for decision-making in women with preeclampsia. Dipstick proteinuria performs as well as other methods of assessing proteinuria for prediction of adverse events.

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