Urinary inositol phosphoglycan-P type: near patient test to detect preeclampsia prior to clinical onset of the disease. A study on 416 pregnant Mauritian women.

Preeclampsia and eclampsia account for major pregnancy complications in Mauritius, an emerging country (maternal mortality rate of 60 per 100,000 deliveries). This prospective longitudinal study was carried out in the main regional hospital in the north of the island, to measure inositol phosphoglycan-P type (IPG-P) in the urine of pregnant women (using an ELISA-based assay). Women had approximately 10 prenatal visits per pregnancy and a complete follow-up in this same referral centre after the first trimester of pregnancy. Urine samples were collected every 1-4 weeks in all women. In a cohort of 416 patients, preeclampsia (PE) was diagnosed in 34 women. In established PE (hypertension and proteinuria), the assay as a diagnostic test showed a positive likelihood ratio of 18.73, a negligible negative likelihood ratio with area under the curve (AUC) of 0.99, sensitivity of 96.7%, specificity of 94.8% and remained negative in control women (n=312), women with gestational hypertension (without proteinuria (n=56), and gestational diabetic mothers (n=14). Moreover, as a predictive screening test two weeks before the diagnosis of PE, the assay showed sensitivity of 84.2% and specificity of 83.6%. Detection of urinary inositol phosphoglycan-P type in pregnant women can be a useful confirmatory marker of PE, as well as a predictive marker, two weeks before the onset of the disease.