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子痫前期患者血清尿酸水平对围产期不良结局的预测价值

Predictive value of serum uric acid levels for adverse perinatal outcomes in preeclampsia.

作者信息

Ryu Aelie, Cho Nam Jun, Kim Yun Sook, Lee Eun Young

机构信息

Department of Obstetrics and Gynecology.

Department of Nephrology, College of Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.

出版信息

Medicine (Baltimore). 2019 May;98(18):e15462. doi: 10.1097/MD.0000000000015462.

Abstract

Preeclampsia is a multisystem disorder associated with pregnancy and is a common cause of perinatal morbidity. The aim of this study was to determine whether elevated serum uric acid levels, alone or in combination with other laboratory factors could predict preeclampsia in women with adverse perinatal outcomes.We conducted a prospective observational study of women who were admitted to Soonchunhyang University Cheonan Hospital from January 2016 to December 2016. Demographic, clinical and laboratory data were collected for each pregnancy at the time of delivery. Women were grouped according to status (preeclampsia or normotensive), and a logistic regression analysis was used to determine the relationship between serum uric acid levels and adverse outcomes.The mean age of the study participants was 31.3 ± 5.0 years. In patients with preeclampsia, serum uric acid level was associated with the severity of preeclampsia, including blood pressure (R = 0.321, P = .014), serum creatinine levels (R = 0.505, P < .001), and proteinuria (P = .014), as well as adverse fetal outcomes, including preterm labor (P = .027) and low birth weight delivery (P = .001). The optimal maternal serum uric acid threshold that predicted low birth weight at delivery was 6.35 mg/dL (sensitivity, 0.58; specificity, 0.95). The multivariable logistic regression model that was used to predict low birth weight at delivery displayed an area under the receiver-operating characteristic curve of 0.902 (95% confidence interval, 0.817-0.986).In women with preeclampsia, maternal serum uric acid level is an important parameter for predicting low birth weight. Additionally, the combination of uric acid, hemoglobin, and bilirubin levels appear to be optimal for predicting low birth weight in women with preeclampsia.

摘要

子痫前期是一种与妊娠相关的多系统疾病,是围产期发病的常见原因。本研究的目的是确定血清尿酸水平升高单独或与其他实验室因素联合是否能预测围产期结局不良的女性患子痫前期的情况。

我们对2016年1月至2016年12月入住顺天乡大学天安医院的女性进行了一项前瞻性观察研究。在分娩时收集每次妊娠的人口统计学、临床和实验室数据。根据状态(子痫前期或血压正常)对女性进行分组,并使用逻辑回归分析来确定血清尿酸水平与不良结局之间的关系。

研究参与者的平均年龄为31.3±5.0岁。在子痫前期患者中,血清尿酸水平与子痫前期的严重程度相关,包括血压(R = 0.321,P = 0.014)、血清肌酐水平(R = 0.505,P < 0.001)和蛋白尿(P = 0.014),以及不良胎儿结局,包括早产(P = 0.027)和低体重儿分娩(P = 0.001)。预测分娩时低体重儿的最佳母体血清尿酸阈值为6.35mg/dL(敏感性,0.58;特异性,0.95)。用于预测分娩时低体重儿的多变量逻辑回归模型显示,受试者工作特征曲线下面积为0.902(95%置信区间,0.817 - 0.986)。

在子痫前期女性中,母体血清尿酸水平是预测低体重儿的重要参数。此外,尿酸、血红蛋白和胆红素水平的联合似乎最适合预测子痫前期女性的低体重儿情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d6c/6504307/5e3fe4c1150f/medi-98-e15462-g002.jpg

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