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Evaluation of the value of calcium to creatinine ratio for predicting of pre-eclampsia

Introduction: Pre-eclampsia is one of the most serious complications in pregnancy and is one of the major causes of maternal death. Therefore, its prediction has special importance and many studies have been performed on different materials, which may be useful for its prediction. Objective: The purpose of the present study is to evaluate the calcium to creatinine ratio for the prediction of pre-eclampsia. Method: A prospective cohort study was performed on 150 pregnant women, who were aged from 15 to 35 years. A single urine sample was obtained at 20–24 weeks of gestation for measurement of urine calcium to creatinine ratio. The women were then monitored for delivery and this ratio was compared between the women with and without pre-eclampsia. Results: Mean urine calcium of pre-eclamptic women was significantly lower than normotensive women (179 ± 35 mg/dl vs 272 ± 59 mg/dl, P < 0.001). Mean calcium to creatinine ratio was significantly lower in pre-eclamptic women (0.07 ± 0.007 vs 0.16 ± 0.006, P < 0.001). The optimal cut off point for calcium to creatinine ratio was calculated to be 0.071 with a sensitivity of 77% and specificity of 78%. Conclusion: Urine calcium and calcium to creatinine ratio are lower in pre-eclamptic women and may be used as a screening test for the prediction of pre-eclampsia.