Cross‐sectional diagnostic accuracy study of self‐testing for proteinuria during hypertensive pregnancies: The UDIP study. (12th May 2022)

• Record Type: Journal Article
• Authors: Jakubowski, Bethany Ellen; Stevens, Richard; Wilson, Hannah; Lavallee, Layla; Brittain, Lesley; Crawford, Carole; Hodgkinson, James; Hinton, Lisa; Mackillop, Lucy; Chappell, Lucy C.; McManus, Richard J.; Tucker, Katherine Louise
• Is Part Of: BJOG. Volume 129:Number 13(2022)
• Page Start: 2142
• Page End: 2148
• Publication Date: 2022-05-12
• Subjects: diagnostic accuracy study -- hypertension -- pre‐eclampsia -- pregnancy -- proteinuria -- self‐testing; Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1111/1471-0528.17180
• Languages: English
• ISSNs: 1470-0328

Abstract

Abstract: 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. Abstract : Linked article : This article is commented on by Wessel Ganzevoort, pp. 2149 in this issue. To view this mini commentary visit https://doi.org/10.1111/1471‐0528.17202