Uric Acid as a predictor of adverse maternal and perinatal outcomes in women hospitalized with preeclampsia.

Abstract

OBJECTIVE:

Elevated serum uric acid is commonly observed in women with preeclampsia, but its utility in predicting adverse outcomes has recently been disputed. Our goal was to analyze data from a large cohort of women with preeclampsia to determine the utility of serum uric acid in predicting adverse maternal and perinatal outcomes.

METHODS:

Data were obtained from an ongoing international prospective study of women admitted to hospital with preeclampsia (Pre-eclampsia Integrated Estimate of RiSk). Univariate logistic regression was used to determine the relationship between serum uric acid concentration (both absolute and gestational-age corrected [Z score]) and adverse outcomes (maternal and perinatal). Analyses were conducted to compare cohorts of women with preeclampsia as defined by hypertension and proteinuria versus hypertension and hyperuricemia.

RESULTS:

Uric acid Z score was associated with adverse perinatal outcome (OR 1.5; 95% CI 1.4 to 1.7) and had a point estimate > 0.7 (area under the curve receiver operating characteristic 0.72; 95% CI 0.69 to 0.74). Serum uric acid concentration also showed a significant association with adverse maternal outcomes, but the point estimate was < 0.7. No significant differences were observed between groups in which preeclampsia was defined by hypertension and proteinuria and by hypertension and hyperuricemia.

CONCLUSION:

In women admitted to hospital with preeclampsia, the serum uric acid concentration, corrected for gestational age via a Z score, is clinically useful in predicting adverse perinatal outcomes but not maternal outcomes.

• Authors: Joel R Livingston, Beth Payne, Mark Brown, James M Roberts, Anne-Marie Côté, Laura A Magee, Peter von Dadelszen, PIERS Study Group
• Journal: Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC (J Obstet Gynaecol Can) Vol. 36 Issue 10 Pg. 870-877 (Oct 2014) ISSN: 1701-2163 [Print] Netherlands
• PMID: 25375299 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Uric Acid

Topics

• Adult
• Cohort Studies
• Female
• Humans
• Pre-Eclampsia (blood)
• Predictive Value of Tests
• Pregnancy
• Pregnancy Outcome
• Risk Factors
• Uric Acid (blood)