Evaluation of Urinary Calcium Creatinine ratio in Preeclampsia at Mansoura University Hospitals

Background: Preeclampsia is a multisystem hypertensive condition of gestation related to significant neonatal and maternal morbidity. Identifying early predictors remains a priority for improving outcomes. The urinary calcium/creatinine ratio (UCCR) has been suggested as a non-invasive tool for this purpose. Aim: To assess the urinary calcium/creatinine ratio (ca/cr ratio) in women had preeclampsia compared to normotensive pregnancies and correlate UCCR levels with the degree of preeclampsia. Patients and Methods: This cross-sectional case-control research involved 102 pregnant women at twenty weeks or more of gestation, separated into 3 groups: Group A (normotensive controls), Group B (mild preeclampsia), and Group C (severe preeclampsia), with 34 participants in each group. All participants underwent history taking, clinical assessment, laboratory tests, and UCCR evaluation from midstream urine samples. Results: Median UCCR values were significantly lower in preeclampsia groups: 0.03 in mild and 0.02 in severe cases versus 0.18 in normotensive controls (p<0.001). UCCR showed strong discriminatory power with cut-off values of ≤0.095 for mild and ≤0.155 for severe preeclampsia (AUC = 0.841 and 0.875, respectively). Positive correlations were found between UCCR and BMI (p=0.01) in controls, gravidity in mild cases (p=0.04), and platelet count in severe cases (p=0.017). Conclusion: Urinary calcium/creatinine ratio is significantly decreased in preeclampsia and correlates with disease severity. It serves as a simple, cost-effective, and reliable screening tool for early prediction of preeclampsia. Key Words: Preeclampsia, Urinary calcium/creatinine ratio, Hypertension in pregnancy, Prediction, Screening tool