The value of serum uric acid in predicting adverse pregnancy outcomes of women with hypertensive disorders of pregnancy
Abstract
Objectives: This study aims to investigate the clinical value of uric acid in predicting adverse pregnancy outcomes (APOs) of women with hypertensive disorders of pregnancy.
Material and methods: A total of 180 pregnant women with HDP from September 2015 to January 2017 were selected for this study. These subjects were classified into two groups, according to serum uric acid level: high UA group (n = 137) and normal UA group (n = 43). In addition, 180 healthy pregnant women were selected and assigned as the control group (n = 180). The monitored biochemical indices and APOs in these three groups were analyzed. Furthermore, non-conditional logistic regression analysis was performed to determine influencing factors of APOs in women with HDP and hyperuricemia.
Results: The non-conditional multi-factor logistic regression analysis revealed that HUA (SUA > 357 umol/L) is the risk factor of APOs in women with HDP (OR = 1.258, P < 0.05).
Conclusions: Women with HDP and HUA are often accompanied with a variety of abnormal biochemical indicators, and is correlated with the severity of the disease and APOs.
Keywords: hyperuricemiahypertensive disordersof pregnancyrisk factorperinatal outcomes
References
- Stander HF, Cadden JF. Blood chemistry in preeclampsia and eclampsia. Am J ObstetGynecol. 1934; 28: 856.
- Paula LG, da Costa BE, Poli-de-Figueiredo CE, et al. Does uric acid provide information about maternal condition and fetal outcome in pregnant women with hypertension? Hypertens Pregnancy. 2008; 27(4): 413–420.
- Bellomo G, Venanzi S, Saronio P, et al. Prognostic significance of serum uric acid in women with gestational hypertension. Hypertension. 2011; 58(4): 704–708.
- Elmas O, Elmas O, Aliciguzel Y, et al. The relationship between hypertension and plasma allantoin, uric acid, xanthine oxidase activity and nitrite, and their predictive capacity in severe preeclampsia. J Obstet Gynaecol. 2016; 36(1): 34–38.
- Agrawal S, Maitra N. Prediction of Adverse Maternal Outcomes in Preeclampsia Using a Risk Prediction Model. J Obstet Gynaecol India. 2016; 66(Suppl 1): 104–111.
- Hawkins TLA, Roberts JM, Mangos GJ, et al. Plasma uric acid remains a marker of poor outcome in hypertensive pregnancy: a retrospective cohort study. BJOG. 2012; 119(4): 484–492.
- Chen Q, Lau S, Tong M, et al. Serum uric acid may not be involved in the development of preeclampsia. J Hum Hypertens. 2016; 30(2): 136–140.
- Chinese Medical Association Chinese society of obstetrics and Gynecology pregnancy induced hypertension study group. Guidelines to the diagnosis and treatment of hypertensive disorders in pregnancy. Chinese Journal of Obstetrics and Gynecology. 2012; 47(6): 476–480.
- Dayi H, Rongjin D. The Chinese expert consensus in diagnosis and treatment ofasymptomatic hyperuricemia in cardiovascular disease. Chinese General Practice. 2010; 13: 1145–1149.
- Xing X, Wenli G. Gynecology and obstetrics. 8th Edition. People's Medical Publishing House, Beijing 2013: 64–75.
- Rock KL, Kataoka H, Lai JJ. Uric acid as a danger signal in gout and its comorbidities. Nat Rev Rheumatol. 2013; 9(1): 13–23.
- Jalal DI, Chonchol M, Chen W, et al. Uric acid as a target of therapy in CKD. Am J Kidney Dis. 2013; 61(1): 134–146.
- Soltani Z, Rasheed K, Kapusta DR, et al. Potential role of uric acid in metabolic syndrome, hypertension, kidney injury, and cardiovascular diseases: is it time for reappraisal? Curr Hypertens Rep. 2013; 15(3): 175–181.
- QiuChunhong, QiuChundong. Relationship between uric acid and clinical diseases. Medical Recapitulate. 2009; 15: 3135–3137.
- Xiaoli W, Wenhui D. Hypertensive disorders in pregnancy and hyperuricemia. Chinese Journal of Reproductive Health. 2013; 24: 86–88.
- Singh A, Sharma P, Malla R, et al. Raised Uric Acid Level and Fetal Outcome in Hypertensive Disorders of Pregnancy. Nepal Journal of Obstetrics and Gynaecology. 2014; 9(1).
- Livingston J, Payne B, Brown M, et al. Uric Acid as a Predictor of Adverse Maternal and Perinatal Outcomes in Women Hospitalized With Preeclampsia. Journal of Obstetrics and Gynaecology Canada. 2014; 36(10): 870–877.
- Akahori Y, Masuyama H, Hiramatsu Y. The correlation of maternal uric acid concentration with small-for-gestational-age fetuses in normotensive pregnant women. Gynecol Obstet Invest. 2012; 73(2): 162–167.
- Payne BA, Hutcheon JA, Ansermino JM, et al. miniPIERS Study Working Group. A risk prediction model for the assessment and triage of women with hypertensive disorders of pregnancy in low-resourced settings: the miniPIERS (Pre-eclampsia Integrated Estimate of RiSk) multi-country prospective cohort study. PLoS Med. 2014; 11(1): e1001589.
- Magee L, Pels A, Helewa M, et al. Diagnosis, evaluation, and management of the hypertensive disorders of pregnancy. Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health. 2014; 4(2): 105–145.
- Cnossen JS, de Ruyter-Hanhijärvi H, van der Post JAM, et al. Accuracy of serum uric acid determination in predicting pre-eclampsia: a systematic review. Acta Obstet Gynecol Scand. 2006; 85(5): 519–525.
- Thangaratinam S, Ismail KMK, Sharp S, et al. Tests in Prediction of Pre-eclampsia Severity review group. Accuracy of serum uric acid in predicting complications of pre-eclampsia: a systematic review. BJOG. 2006; 113(4): 369–378.
- Urato AC, Bond B, Craigo SD, et al. Admission uric acid levels and length of expectant management in preterm preeclampsia. J Perinatol. 2012; 32(10): 757–762.