A cross-sectional comparative study to assess the role of spot urinary calcium to creatinine ratio in prediction of preeclampsia

Background: Preeclampsia is a hypertensive disorder unique to pregnancy, associated with significant maternal and fetal morbidity and mortality. Early prediction and diagnosis are critical for better clinical outcomes. Biochemical markers such as the spot urinary calcium to creatinine ratio (UCa/Cr) have been proposed as a non-invasive, cost-effective tool for identifying preeclampsia. Objective of the study was to evaluate and compare the spot urinary calcium to creatinine ratio in pregnant women with and without preeclampsia and assess its diagnostic utility. Methods: This cross-sectional comparative study was conducted on pregnant women in the third trimester attending antenatal clinics or admitted to the obstetric unit. Participants were divided into two groups: women diagnosed with preeclampsia (study group) and normotensive pregnant women (control group). A midstream urine sample was collected from each participant for calcium and creatinine estimation, and the UCa/Cr ratio was calculated. The two groups were statistically compared using appropriate tests. Results: The mean UCa/Cr ratio was significantly lower in the preeclamptic group compared to the normotensive controls (p<0.001). A UCa/Cr cutoff value of <0.04 demonstrated good sensitivity and specificity in identifying preeclampsia. Conclusions: The spot urinary calcium to creatinine ratio is a simple, non-invasive, and reliable test that may serve as an adjunct tool for the early detection and diagnosis of preeclampsia. Further large-scale studies are recommended to validate its clinical applicability.