Department of Medical Records, Foshan Women and Children Hospital, Foshan city, Guangdong Province, 528000, China.
Department of Obstetrics, Foshan Institute of Fetal Medicine, Foshan Women and Children Hospital, Foshan city, Guangdong Province, 528000, People's Republic of China.
BMC Endocr Disord. 2023 Nov 20;23(1):252. doi: 10.1186/s12902-023-01502-3.
Previous evidence suggests that higher blood uric acid (UA) levels are associated with adverse cardiovascular outcomes during pregnancy and subsequent birth outcomes. However, it has been relatively unclear whether these associations persist in normotensive pregnant women.
The study was based on a retrospective analysis of 18,250 mother-infant pairs in a large obstetric center in China. Serum UA concentrations in early pregnancy (median: 17.6, IQR: 16.3, 18.6 gestational weeks) were assessed. Hyperuricemia was defined as ≥ one standard deviation (SD) of the reference value for the corresponding gestational age. Outcomes of gestational diabetes mellitus (GDM), preterm birth (PB), low birth weight (LBW), macrosomia, small for gestational age (SGA) and large for gestational age (LGA) were extracted from the medical records.
The mean maternal UA level was 0.22 ± 0.05 mmol/L, and 2,896 (15.9%) subjects had hyperuricemia. After adjustment for several covariates, UA was associated with several adverse outcomes. The ORs (95%CI) per one SD increase in serum UA concentration were 1.250 (1.136, 1.277) for GDM, 1.137 (1.060, 1.221) for PB, 1.134 (1.051, 1.223) for LBW, and 1.077 (1.020, 1.137) for SGA, respectively. Similar adverse associations were found between hyperuricemia and GDM, PB (ORs: 1.394 and 1.385, P < 0.001), but not for LBW, macrosomia, SGA, and LGA. Adverse associations tended to be more pronounced in subjects with higher BMI for outcomes including PB, LBW, and SGA (P interaction = 0.001-0.028).
Higher UA levels in early pregnancy were associated with higher risk of GDM, PB, LBW, and SGA in normotensive Chinese women.
先前的证据表明，较高的血尿酸（UA）水平与妊娠期间及随后的出生结局不良的心血管结局有关。然而，在血压正常的孕妇中，这些关联是否仍然存在尚不清楚。
本研究基于中国一家大型产科中心对 18250 对母婴对的回顾性分析。评估了早孕期（中位数：17.6，IQR：16.3，18.6 孕周）血清 UA 浓度。高尿酸血症定义为相应妊娠年龄参考值的一个标准差（SD）以上。从病历中提取妊娠期糖尿病（GDM）、早产（PB）、低出生体重（LBW）、巨大儿、小于胎龄儿（SGA）和大于胎龄儿（LGA）的结局。
母亲 UA 水平的平均值为 0.22±0.05mmol/L，2896 名（15.9%）受试者存在高尿酸血症。在校正了几个协变量后，UA 与多种不良结局相关。血清 UA 浓度每增加一个 SD，GDM 的 OR（95%CI）为 1.250（1.136，1.277），PB 为 1.137（1.060，1.221），LBW 为 1.134（1.051，1.223），SGA 为 1.077（1.020，1.137）。高尿酸血症与 GDM、PB 之间也存在类似的不良关联（ORs：1.394 和 1.385，P<0.001），但与 LBW、巨大儿、SGA 和 LGA 无关。对于包括 PB、LBW 和 SGA 在内的结局，在 BMI 较高的受试者中，不良关联的趋势更为明显（P 交互=0.001-0.028）。
早孕期 UA 水平升高与血压正常的中国女性发生 GDM、PB、LBW 和 SGA 的风险增加有关。
