Journal
BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY
Volume 129, Issue 13, Pages 2142-2148Publisher
WILEY
DOI: 10.1111/1471-0528.17180
Keywords
diagnostic accuracy study; hypertension; pre-eclampsia; pregnancy; proteinuria; self-testing
Categories
Funding
- National Institute for Health Research (NIHR) [RP-PG-0614-20 005, NIHR-RP-R2-12-015]
- National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research (CLAHRC)
- Primary Care Research Trust
- Health Foundation
- NIHR Oxford Biomedical Research Centre
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The study aimed to determine the accuracy of self-testing for proteinuria during pregnancy. The results showed that pregnant women can visually read a dipstick for urinary protein with similar accuracy to antenatal healthcare professionals. Self-testing has the potential to be part of self-monitoring during pregnancy.
Objective To determine the accuracy of self-testing for proteinuria during pregnancy. Design Diagnostic accuracy study. Setting Antenatal clinics, maternity assessment units and inpatient wards at three hospital sites. Population or Sample 345 pregnant women. Methods Pregnant women self-tested in-clinic for urinary protein using visually read dipsticks with samples then sent for laboratory estimation of the spot protein-creatinine ratio (PCR) (primary reference test). Secondary index tests included testing by antenatal healthcare professionals and an automated colorimetric reader. Main outcome measures Sensitivity, specificity, negative predictive value, positive predictive value and likelihood ratios were calculated for self-testing (primary index test) along with healthcare professional and colorimetric testing compared to the primary reference test (PCR). Results 335/345 (97%) had sufficient data to be included in the analysis. Self-testing had a sensitivity of 0.71 (95% confidence interval [CI] 0.62-0.79) and a specificity of 0.89 (95% CI 0.84-0.92) compared to PCR. Sensitivity and specificity of testing by healthcare professionals and the colorimetric reader were similar: sensitivity 0.73 (95% CI 0.64-0.80) and 0.78 (95% CI 0.69-0.85), respectively; specificity 0.88 (95% CI 0.82-0.92) and 0.83 (95% CI 0.78-0.88), respectively. Conclusion Pregnant women can visually read a dipstick for urinary protein with similar accuracy to antenatal healthcare professionals. Automated colorimetric testing was not significantly different, in contrast to some previous studies. Self-testing has the potential to form part of a self-monitoring regime in pregnancy.
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