Cardiovascular Internal Medicine Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna.
University of Bologna, Department of Medical and Surgical Sciences.
J Hypertens. 2023 Aug 1;41(8):1333-1338. doi: 10.1097/HJH.0000000000003472. Epub 2023 Jun 5.
Preeclampsia is one of the most severe diseases among the hypertensive disorders of pregnancy (HDP) and the leading cause of maternal and fetal morbidity and mortality. It is of crucial importance to early identify women at a high risk for preeclampsia to implement appropriate preventive strategies. In our study, we aimed to test the hypothesis that serum uric acid to creatinine ratio (SUA/sCr) is related to the development of preeclampsia and maternal and neonatal complications.
We searched for uric acid and creatine values in the medical records of 269 women who consecutively attended our HDP Clinic from December 2018 to December 2022. We compared the baseline characteristics of participants with normotensive pregnancy ( n = 57), to those with HDP without preeclampsia (HDP-non-PE) ( n = 100) and those with preeclampsia ( n = 112), and we performed adjusted logistic regression analysis to test the associations between SUA/sCr and the development of preeclampsia and maternal and neonatal complications.
SUA/sCr was consistently higher in women with preeclampsia in all trimesters of pregnancy. Higher SUA/sCr at the third trimester was associated with an increased odd of developing preeclampsia [odds ratio (OR) 1.29, confidence interval (CI) 1.15-1.50, P = 0.001], preterm birth (OR 1.23, CI 1.05-1.45, P = 0.011), and composite neonatal outcome (OR 1.33, CI 1.12-1.59, P = 0.001), after adjustment for age, BMI before pregnancy, nulliparity, antihypertensive therapy, and acetylsalicylic acid therapy during pregnancy.
Having higher SUA/sCr during pregnancy is associated with the development of PE and adverse pregnancy outcomes. Controlled prospective studies are warranted to clarify the predictive power of this novel marker during pregnancy.
子痫前期是妊娠高血压疾病（HDP）中最严重的疾病之一，也是孕产妇和胎儿发病率和死亡率的主要原因。早期识别子痫前期高危妇女并实施适当的预防策略至关重要。在我们的研究中，我们旨在检验血清尿酸与肌酐比值（SUA/sCr）与子痫前期及母婴并发症发生相关的假设。
我们在 2018 年 12 月至 2022 年 12 月期间连续就诊于 HDP 诊所的 269 名女性的病历中查找尿酸和肌酐值。我们比较了正常妊娠（n=57）、无子痫前期的 HDP（HDP-non-PE）（n=100）和子痫前期（n=112）患者的基线特征，并进行了调整后的逻辑回归分析，以检验 SUA/sCr 与子痫前期和母婴并发症发生的相关性。
SUA/sCr 在妊娠各期子痫前期患者中均持续升高。第三孕期较高的 SUA/sCr 与子痫前期发生风险增加相关[比值比（OR）1.29，95%置信区间（CI）1.15-1.50，P=0.001]、早产（OR 1.23，95%CI 1.05-1.45，P=0.011）和复合新生儿结局（OR 1.33，95%CI 1.12-1.59，P=0.001），校正年龄、妊娠前 BMI、初产妇、降压治疗和孕期使用乙酰水杨酸治疗后。
妊娠期间 SUA/sCr 升高与 PE 及不良妊娠结局相关。需要进行对照前瞻性研究以明确该新型标志物在孕期的预测能力。
