Maternal serum uric acid concentration and pregnancy outcomes in women with pre-eclampsia/eclampsia

Abstract

Objectives: To determine the relationship between maternal serum uric acid levels and fetal/neonatal complications in women with pre-eclampsia/eclampsia, and to establish a predictive threshold value.

Methods: A diagnostic test and historical cohort study conducted by prospective cross-sectional data collection on pregnant women with pre-eclampsia/eclampsia at Hue University Hospital, Vietnam, between March 2015 and July 2017. Pre-eclampsia was diagnosed based on ACOG criteria. Serum uric acid levels were measured by enzymatic colorimetric testing using a Cobas c 501 analyzer (Roche Diagnostics, Mannheim, Germany). Fetal complications included intrauterine growth restriction, preterm delivery, fetal death, and neonatal death.

Results: There were 205 women enrolled. Serum uric acid at a cutoff of 393 μmol/L is a good predictor of fetal/neonatal complications (AUC 0.752), with 64.4% sensitivity and 79.5% specificity. High uric acid level (≥393 μmol/L) resulted in increased risk of preterm birth (OR 6.367, 95% CI 3.009-13.084), low Apgar scores (OR 5.514, 95% CI 1.877-16.198), intrauterine growth restriction (OR 7.188, 95% CI 3.592-14.382), and neonatal death (OR 7.818, 95% CI 1.614-37.867). There was no relationship between uric acid level and fetal death (OR 1.803, 95% CI 0.355-9.168).

Conclusions: Maternal serum uric acid concentration is a good predictor of fetal/neonatal outcomes in women with pre-eclampsia/eclampsia.

Keywords: Eclampsia; Intrauterine growth restriction; Neonatal complications; Pre-eclampsia; Preterm birth; Uric acid.