Sudjai Dennopporn, Satho Pasika
Department of Obstetrics and Gynecology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand.
J Obstet Gynaecol. 2022 Oct;42(7):2704-2708. doi: 10.1080/01443615.2022.2099254. Epub 2022 Jul 22.
Hyperuricaemia is common in preeclampsia. Its relationship and the utility in predicting of preeclampsia must be evaluated. The objective was to determine the association between maternal serum uric acid level and preeclampsia with or without severe features, including maternal and neonatal outcomes. A retrospective study was conducted at Rajavithi Hospital between June 2015 and May 2019. Inferential analysis comparison using binary logistic regression analysis and correlation using Chi-Square test/Fisher's exact test were used for analysis. Among the 400 participants, 331 (82.7%) women were preeclampsia with severe features. The mean uric acid level was significantly higher in women with preeclampsia with severe features compared to those without (6.44 ± 1.44 vs 5.87 ± 1.53 mg/dL, -value = .016). Uric acid greater than 7 mg/dL was associated with renal involvement and preeclampsia with severe features. Uric acid 5-7 and greater than 7 mg/dL correlated with preterm birth (OR 2.67, 95% CI 1.59-4.49 and OR 4.89, 95% CI 2.75-8.68, respectively). Uric acid greater than 7 mg/dL also increased the risk of RDS and NICU admission. In conclusion, a high uric acid level is associated with preeclampsia with severe features and adverse pregnancy outcomes and may be the predictor of the severity of preeclampsia.Impact statement Hyperuricaemia is a common finding in preeclamptic pregnancy due to reduction of uric acid clearance secondary to reduced glomerular filtration rate, increased reabsorption, and decreased secretion. The correlation of increase maternal uric acid level and preeclampsia including adverse pregnancy outcomes has been evaluated and supported the use of uric acid as a predictor for preeclampsia development. However, its clinical utility is still debateable. The present study demonstrated the association between higher maternal serum uric acid level and severity of preeclampsia. Particularly, serum uric acid greater than 7 mg/dL was associated with preeclampsia with severe features. Additionally, serum uric acid level 5-7 mg/dL and greater than 7 mg/dL had a positive correlation with adverse maternal and neonatal outcomes. Maternal serum uric acid may be used as the predictor of severity of preeclampsia. However, the sensitivity and specificity and the precise clinical utility of uric acid related to preeclampsia need to be further evaluated in larger sample size.
高尿酸血症在子痫前期中很常见。必须评估其与子痫前期的关系以及在预测子痫前期方面的效用。目的是确定母体血清尿酸水平与伴有或不伴有严重特征的子痫前期之间的关联，包括母体和新生儿结局。2015年6月至2019年5月在拉贾维提医院进行了一项回顾性研究。分析采用二元逻辑回归分析进行推断性分析比较，采用卡方检验/费舍尔精确检验进行相关性分析。在400名参与者中，331名（82.7%）女性患有伴有严重特征的子痫前期。伴有严重特征的子痫前期女性的平均尿酸水平显著高于无严重特征的女性（6.44±1.44 vs 5.87±1.53mg/dL，P值=0.016）。尿酸大于7mg/dL与肾脏受累和伴有严重特征的子痫前期相关。尿酸5 - 7mg/dL和大于7mg/dL与早产相关（OR分别为2.67，95%CI 1.59 - 4.49和OR 4.89，95%CI 2.75 - 8.68）。尿酸大于7mg/dL也增加了呼吸窘迫综合征和入住新生儿重症监护病房的风险。总之，高尿酸水平与伴有严重特征的子痫前期及不良妊娠结局相关，可能是子痫前期严重程度的预测指标。影响声明高尿酸血症是子痫前期妊娠中的常见表现，这是由于肾小球滤过率降低、重吸收增加和分泌减少导致尿酸清除率下降所致。已评估了母体尿酸水平升高与子痫前期包括不良妊娠结局之间的相关性，并支持将尿酸用作子痫前期发展的预测指标。然而，其临床效用仍存在争议。本研究证明了母体血清尿酸水平升高与子痫前期严重程度之间的关联。特别是，血清尿酸大于7mg/dL与伴有严重特征的子痫前期相关。此外，血清尿酸水平5 - 7mg/dL和大于7mg/dL与不良母体和新生儿结局呈正相关。母体血清尿酸可作为子痫前期严重程度的预测指标。然而，尿酸与子痫前期相关的敏感性、特异性及确切临床效用需要在更大样本量中进一步评估。
