Analysis of the status of spot urine albumin creatinine ratio in pregnancy

Introduction: Urinary albumin-to-creatinine ratio (UACR) has been widely studied as a non-invasive biomarker for detecting and predicting complications in pregnancy. Methods: A prospective cohort of 170 pregnant women was evaluated for UACR levels in all three trimesters. UACR thresholds were derived using receiver operating characteristic (ROC) curve analysis, with clinical diagnoses as the gold standard. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each threshold. Results: Mean UACR values increased progressively across trimesters, from 3.6 (±1.9) mg/g in the first trimester to 189.4 (±214.1) mg/g in the third. A UACR threshold of 316 mg/g in the third trimester achieved high diagnostic accuracy for preeclampsia (sensitivity 96.15%, specificity 97.22%, AUC 0.958). Second-trimester thresholds were predictive for preeclampsia (10.6 mg/g; AUC 0.851), GHTN (8 mg/g; AUC 0.5408), and GDM (8.2 mg/g; AUC 0.5409). Fetal complications (8.6 mg/g; AUC 0.6386) and C-sections (8.4 mg/g; AUC 0.5657) were also significantly associated with second-trimester UACR levels. Conclusion: The study establishes trimester-specific UACR thresholds for identifying and predicting maternal and fetal complications, emphasizing its utility in antenatal care. Incorporating UACR into routine screening could enhance early detection and management of high-risk pregnancies.