Department of Obstetrics & Gynaecology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
Management and Science University Medical Centre, Shah Alam, Selangor, Malaysia.
J Obstet Gynaecol. 2021 Jan;41(1):38-43. doi: 10.1080/01443615.2019.1679731. Epub 2020 Oct 30.
Preeclampsia patients have frequently been found to experience hyperuricaemia and this may result in poor outcomes compared to those with normal uric acid levels. This study aimed to determine the relationship of hyperuricaemia in pre-eclampsia patients with foetal and maternal outcomes. This prospective cohort study involved 79 patients in a tertiary centre from year 2016 to 2018. Blood samples were taken antenatally and at the 6th week, post-delivery for renal function including serum uric acid level. Our findings indicate that there was a higher incidence of poor maternal and foetal outcomes in the hyperuricaemia group than the normal uric acid group. Serum uric acid has been shown to be a significant predictor for low birth weight and premature delivery in preeclampsia patients. It was also found that there was a significant negative correlation between uric acid level and antenatal creatinine clearance ( = -0.338, = .002). The assessment of the serum uric acid level seems to be important to ensure better outcomes in patients with preeclampsia.Impact statement Preeclampsia is a serious pregnancy-related complication and remains as one of the most important cause of maternal and foetal morbidity and mortality, affecting 2-8% in all pregnancy. Many studies have established the association between hyperuricaemia and preeclampsia. Besides, numerous studies have found that hyperuricaemia contributed to adverse maternal and foetal outcomes. There was a significant increase in adverse foetal and maternal outcomes in the hyperuricaemia group compared to the normal uric acid group. This study revealed that serum uric acid remains a significant predictor for low birth weight and premature delivery in preeclampsia patients. Hyperuricaemia does not merely become an indicator for the severity of disease in preeclampsia patients but also indicates adverse foetal outcomes. Large population-based studies are required to establish the absolute maternal and foetal outcomes in patients with hyperuricaemia. Besides, further studies are recommended on long-term implication of hyperuricaemia which is not limited to only during antenatal period.
子痫前期患者常伴有血尿酸升高，与血尿酸水平正常的患者相比，其母婴结局可能较差。本研究旨在探讨子痫前期患者血尿酸升高与母婴结局的关系。本前瞻性队列研究纳入了 2016 年至 2018 年在一家三级中心的 79 例患者。在产前和产后第 6 周采集血样，用于检测肾功能，包括血清尿酸水平。我们的研究结果表明，与血尿酸正常组相比，血尿酸升高组母婴不良结局的发生率更高。血清尿酸已被证明是子痫前期患者低出生体重和早产的重要预测指标。此外，还发现尿酸水平与产前肌酐清除率呈显著负相关（r=-0.338，P=0.002）。评估血清尿酸水平似乎对确保子痫前期患者的良好结局很重要。
影响声明子痫前期是一种严重的妊娠相关并发症，仍是导致母婴发病率和死亡率的最重要原因之一，约占所有妊娠的 2-8%。许多研究已经证实了血尿酸升高与子痫前期之间的关系。此外，大量研究发现血尿酸升高与母婴不良结局有关。与血尿酸正常组相比，血尿酸升高组母婴不良结局发生率显著增加。本研究表明，血清尿酸仍然是子痫前期患者低出生体重和早产的重要预测指标。
血尿酸升高不仅是子痫前期患者疾病严重程度的指标，还预示着不良的胎儿结局。需要进行大规模的基于人群的研究，以确定血尿酸升高患者的母婴绝对结局。此外，建议进一步研究血尿酸升高的长期影响，不仅仅局限于产前阶段。
