Department of Clinical Nutrition, Union Shenzhen Hospital of Huazhong University of Science and Technology, No. 89 Taoyuan Road, Shenzhen, 518052, Guangdong, People's Republic of China.
Department of Obstetrics, Union Shenzhen Hospital Huazhong University of Science and Technology, Shenzhen, People's Republic of China.
Reprod Health. 2022 Sep 15;19(1):192. doi: 10.1186/s12978-022-01496-6.
In recent years, results on the association between serum uric acid (UA) and pregnancy outcomes have been inconsistent, and the association between urea nitrogen (UN) and adverse pregnancy outcomes in normal pregnant women has not been reported. Thus, we examined the association of UA and UN levels during gestation with the risk of adverse pregnancy outcomes in a relatively large population.
A total of 1602 singleton mothers from Union Shenzhen Hospital of Huazhong University of Science and Technology at January 2015 to December 2018 were included. Both UA and UN levels were collected and measured during the second (16-18th week) and third (28-30th week) trimesters of gestation respectively. Statistical analysis was performed using multivariate logistic regression.
After adjustment, the highest quartile of UA in the third trimester increased the risk of premature rupture of membranes (PROM) and small for gestational age infants (SGA) by 48% (odds ratio [OR]: 1.48, 95% confidence interval [CI]: 1.04-2.10) and 99% (95% CI: 1.01-3.89) compared to those in the lowest quartile. The adjusted OR (95% CI) in the highest quartile of UN for the risk of SGA was 2.18 (95% CI: 1.16-4.13) and 2.29 (95% CI: 1.20-4.36) in the second and third trimester, respectively. In the second trimester, when UA and UN levels were both in the highest quartile, the adjusted OR (95% CI) for the risk of SGA was 2.51 (95% CI: 1.23-5.10). In the third trimester, when the group 1 (both indicators are in the first quartile) was compared, the adjusted ORs (95% CI) for the risk of SGA were 1.98 (95% CI: 1.22-3.23) and 2.31 (95% CI: 1.16-4.61) for group 2 (UA or UN is in the second or third quartile) and group 3 (both indicators are in the fourth quartile), respectively.
Higher UA and UN levels increased the risk of maternal and fetal outcomes. The simultaneous elevation of UA and UN levels was a high-risk factors for the development of SGA, regardless of whether they were in the second or third trimester.
近年来，关于血清尿酸（UA）与妊娠结局之间的关系的研究结果并不一致，且关于正常孕妇中尿素氮（UN）与不良妊娠结局之间的关系尚未有报道。因此，我们在一个较大的人群中研究了妊娠期间 UA 和 UN 水平与不良妊娠结局风险之间的关系。
本研究纳入了 2015 年 1 月至 2018 年 12 月在华中科技大学深圳协和医院就诊的 1602 例单胎母亲。分别在妊娠的第二（16-18 周）和第三（28-30 周） trimester 收集并测量 UA 和 UN 水平。使用多变量 logistic 回归进行统计分析。
调整后，第三 trimester 时 UA 的最高四分位组使胎膜早破（PROM）和小于胎龄儿（SGA）的风险分别增加 48%（比值比[OR]：1.48，95%置信区间[CI]：1.04-2.10）和 99%（95% CI：1.01-3.89）。第二和第三 trimester 时 UN 的最高四分位组的 SGA 风险的调整后 OR（95% CI）分别为 2.18（95% CI：1.16-4.13）和 2.29（95% CI：1.20-4.36）。在第二 trimester 时，当 UA 和 UN 水平均处于最高四分位时，SGA 风险的调整后 OR（95% CI）为 2.51（95% CI：1.23-5.10）。在第三 trimester 时，与第 1 组（两个指标均在第 1 四分位）相比，SGA 风险的调整后 ORs（95% CI）分别为 1.98（95% CI：1.22-3.23）和 2.31（95% CI：1.16-4.61）对于第 2 组（UA 或 UN 处于第 2 或第 3 四分位）和第 3 组（两个指标均处于第 4 四分位）。
较高的 UA 和 UN 水平增加了母婴结局的风险。UA 和 UN 水平的同时升高是 SGA 发生的高危因素，无论其发生在第二 trimester 还是第三 trimester。
