A Routine Urine Test Has Partial Predictive Value in Premature Rupture of The Membranes
A Routine Urine Test Has Partial Predictive Value in Premature Rupture of The Membranes
A Routine Urine Test Has Partial Predictive Value in Premature Rupture of The Membranes
the membranes
Abstract
Objective: This study aimed to examine the predictive value of a routine urine test for
premature rupture of the fetal membranes.
Methods: Routine urine test data of 100 patients with preterm premature rupture of the
membranes (PPROM) and 100 patients with full-term premature rupture of the membranes
(PROM) were collected by the case-based method. Additionally, 100 healthy pregnant women
and 100 nonpregnant adult healthy women were selected as the negative control group and blank
control group, respectively. A receiver operating characteristic curve was established after
identifying the different parameters.
Results: We found that occult blood, glucose, ketone bodies, urine specific gravity, red blood cell
count, epithelial cell count, bacteria, yeast, crystals, and electrical conductivity were significantly
different between the PPROM and PROM groups. There were significant differences in occult
blood, protein, glucose, ketone bodies, pH, red blood cell count, bacteria, urine specific gravity,
crystals, and electrical conductivity between the PPROM and full-term groups. Receiver operating
characteristic curve analysis showed that when the cut-off for bacteria was 130.15, it had the
largest area under the curve value of 0.696.
Conclusion: A routine urine test, especially for bacterial counts, has certain predictive value
for PROM.
4
Clinical Laboratory Medicine Center, Qilu Hospital of
1
Hospital Infection Management, Qilu Hospital of Shandong University, Jinan, Shandong Province, China
Shandong University, Qingdao, Shandong Province, China Corresponding author:
2
Department of Stomatology, Qilu Hospital of Shandong Guanghui Zhao, Clinical Laboratory Medicine Center,
University, Qingdao, Shandong Province, China Qilu Hospital of Shandong University, Jinan, Shandong
3
Department of Respiration, Qilu Hospital of Shandong Province 250012, China.
University, Qingdao, Shandong Province, China Email: [email protected]
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2362 Journal of International Medical Research 47(6)
Keywords
Routine urine test, premature rupture of the membranes, receiver operating characteristic curve,
predictive value, preterm, full-term
Date received: 20 December 2018; accepted: 11 March 2019
Normality test
Homogeneity
of variance PPROM PROM Full-term Nonpregnant
Age 6.11 <0.01 0.99 0.43 0.96 0.01 0.88 <0.01 0.10 0.02
Days 75.43 <0.01 0.77 <0.01 0.94 <0.01 0.92 <0.01 – –
LEU 2.48 0.09 0.69 <0.01 0.79 <0.01 0.80 <0.01 – –
BLD 34.02 <0.01 0.70 <0.01 0.44 <0.01 0.43 <0.01 – –
PRO 16.18 <0.01 0.51 <0.01 0.44 <0.01 0.27 <0.01 – –
GLU 38.67 <0.01 0.60 <0.01 0.21 <0.01 0.31 <0.01 – –
KET 37.43 <0.01 0.70 <0.01 0.45 <0.01 0.29 <0.01 – –
UBG 1.15 0.32 0.08 <0.01 0.12 <0.01 0.12 <0.01 – –
BIL 4.08 0.02 – – 0.08 <0.01 – – – –
pH 1.57 0.21 0.94 <0.01 0.94 <0.01 0.92 <0.01 0.19 <0.01
SG 1.46 0.23 0.96 <0.01 0.94 <0.01 0.97 0.02 0.08 0.10
NIT 0.19 0.83 0.08 <0.01 0.08 <0.01 0.08 <0.01 – –
WBCs 1.98 0.14 0.53 <0.01 0.42 <0.01 0.34 <0.01 0.17 <0.01
RBCs 17.71 <0.01 0.29 <0.01 0.27 <0.01 0.12 <0.01 0.18 <0.01
EC 1.19 0.31 0.37 <0.01 0.80 <0.01 0.65 <0.01 0.14 <0.01
Cast 0.73 0.48 0.22 <0.01 0.24 <0.01 0.88 <0.01 0.17 <0.01
P.CAST 1.89 0.15 0.89 <0.01 0.89 <0.01 0.25 <0.01 0.25 <0.01
BAC 0.04 0.96 0.28 <0.01 0.25 <0.01 0.35 <0.01 0.23 <0.01
SRC 2.59 0.08 0.27 <0.01 0.23 <0.01 0.85 <0.01 0.17 <0.01
BYST 4.05 0.02 0.15 <0.01 – – 0.08 <0.01 – –
Crystals 1.33 0.26 0.14 <0.01 0.08 <0.01 0.08 <0.01 0.40 <0.01
Cond. 3.79 0.02 0.97 0.05 0.99 0.50 0.99 0.45 0.05 0.20
PPROM: preterm premature rupture of the membranes; PROM: premature rupture of the membranes; Stat: statistic; days:
days of gestation; LEU: leukocytes; BLD: occult blood; PRO: protein; GLU: glucose; KET: ketone bodies; UBG: urobili-
nogen; BIL: urobilirubin; SG: urine specific gravity; NIT: nitrite; WBCs: white blood cells; RBCs: red blood cells; EC:
epithelial cell count; P.CAST: pathological cast; BAC: bacteria; SRC: small round cells; BYST: yeast; Cond.: electrical
conductivity.
Mann–Whitney U
amount of bacteria was significantly lower related to maternal endocrine function and
in the PPROM group than in the PROM an increase in secreted aldosterone, which
and full-term groups, but there was no dif- could lead to an increase in sodium and
ference between the PPROM and normal chloride reabsorption in the kidney.21
groups. This finding suggested that the We first used non-parametric test meth-
amount of bacteria in the urinary tract in ods to screen differential indicators between
PPORM was significantly reduced, the PPROM and normal groups. ROC
although it was still higher than that in curves were then used to further select indi-
the normal group. The decrease in bacteria cators with good sensitivity, specificity,
is a risk factor, indicating a decrease in the PPV, NPV, þLR, and LR. However,
diversity of flora. Crystals and electrical this study has some limitations. The main
conductivity were significantly reduced in limitation is that none of the metrics
the PPROM group. This low electrical con- showed high enough AUC values. This
ductivity in the PPROM group may be also indicates that use of these indicators
2368 Journal of International Medical Research 47(6)
Figure 1. ROC curve of different indicators. (a) BAC; (b) crystals; (c) Cond.; (d) BACþcrystals;
(e) BACþCond.; (f) crystalsþCond. AUC: area under the curve; ROC: receiver operating characteristic;
BAC: bacteria; Cond.: electrical conductivity.
Liang et al. 2369
Youden
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