Protein:Creatinine Ratio in Random Urine Samples Is a Reliable Marker of Increased 24-Hour Protein Excretion in Hospitalized Women with Hypertensive Disorders of Pregnancy

Background: The protein:creatinine ratio in random, untimed urine samples correlates with 24-h protein excretion in pregnant women with and without hyper-tension. Nevertheless, whether this ratio is appropriate as a screening test for proteinuria is still unclear, in part because of the paucity of large studies. Methods: We measured protein:creatinine ratios in ran-dom urine samples and protein contents of 24-h urine samples in a cross-sectional study of 927 hospitalized pregnant women at>20-weeks of gestational age and in a 2nd cohort of 161 pregnant women. In the 2nd group, urine specimens were obtained before and after comple-tion of the 24-h collections, avoiding 1st-morning void specimens. Results: Protein excretion was>300 mg/24 h in 28