Clinical factors associated with urinary albumin-to-creatinine ratio among pregnant women with preeclampsia

Abstract Objective To analyse clinical factors associated with urinary albumin-to-creatinine ratio among women with preeclampsia. Design & Methods A prospective cohort analysis was conceived at Amana referral regional hospital. Women with preeclampsia (exposed group) were compared with women without evidence of preeclampsia (control group) from any time after 20 th week of pregnancy to at most 24-hours post-delivery. A simple random sampling with 1:1 matching was used to get study participants. Each participant was admitted for a duration of at least 24-hours at baseline for estimation of urinary-based albumin-creatinine ratio via 24-urine collection. Clinical Report Form was the main tool for data collection. A multivariable linear model was set for final analysis after appropriate linear model assumption validation. Results We successfully recruited and prospectively analysed a total of 55440 women-hours of follow-up between January to June 2025. Systolic blood pressure (A.O.R.: 1.01, 95% C.I.: 1.00 – 1.77), diastolic blood pressure (A.O.R.: 1.12, 95% C.I.: 1.00 – 1.97), Caesarean delivery (A.O.R.: 1.19, 95% C.I.: 1.02 – 1.45), neonatal birth weight (A.O.R.: 2.0, 95% C.I.: 1.2 – 2.9) as well as newborn’s 5 th minute Apgar score (A.O.R.: 1.07, 95% C.I.: 1.0 – 1.33) were factors significantly associated with maternal urinary-based albumin-to-creatinine ratio in this study population. Conclusion Diastolic blood pressure had a higher risk than systolic blood pressure to predict significant proteinuria. Newborn’s birth weight as well as 5 th minute Apgar score were immediate outcomes associated with maternal significant proteinuria. Recommendations Fetal maternal calculators for predicting/prognosticating significant proteinuria among pregnant women with proteinuric preeclampsia are warranted.