Albumin-to-Creatinine Ratio in Random Urine Samples Might Replace 24-h Urine Collections in Screening For Micro- and Macroalbuminuria in Pregnant Woman With Type 1 Diabetes
- Thomas I. Justesen, MD1,
- Jens L.A. Petersen, MD1,
- Pia Ekbom, MD, PHD1,
- Peter Damm, MD, DMSC2 and
- Elisabeth R. Mathiesen, MD, DMSC1
- 1Department of Endocinology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
- 2Department of Obstetrics, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
- Address correspondence and reprint requests to Elisabeth R. Mathiesen, Department of Endocrinology, Rigshospitalet, University Hospital of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. E-mail: em{at}rh.dk
Pre-eclampsia, a clinical syndrome of unknown etiology, is among the most common reasons for perinatal and maternal mortality (1). The incidence of pre-eclampsia in women with type 1 diabetes is considerably higher (10–20%) than in the background population (4–5%) (2). Microalbuminuria, defined as a urinary albumin excretion from 30 to 300 mg/24 h before or in early pregnancy has proven to be a good risk marker for pre-eclampsia in women with type 1 diabetes (3). However, the urinary albumin status is often not known at booking for pregnancy. The traditional method for diagnosing microalbuminuria, collection of 24-h urine samples, is cumbersome and time consuming and may be associated with collection errors and poor compliance.
The aim of this study was to determine whether measurement of the albumin-to-creatinine ratio in random urine samples can replace 24-h urine collection in screening for micro- and macroalbuminuria in pregnant women with type 1 diabetes.
RESEARCH DESIGN AND METHODS
The study was conducted at Copenhagen University Hospital from 2000 to 2003. All women with type 1 diabetes who were admitted to our obstetric department before 14 weeks of gestation were asked to participate, and 119 women were enrolled.
The women were asked to make two 24-h urine collections and two random urine samples. The samples were collected between gestational weeks 7 and 22, since we previously have found the urinary albumin excretion …
