Omar Wehlie Hani, Fajardo Tornes Yarine, Businge Julius, Byamukama Onesmus, Kayondo Musa, Kato Kalyebara Paul, Ngonzi Joseph, Lugobe Henry Mark, Ainomugisha Brenda, Tibaijuka Leevan
Department of Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, Uganda.
Department of Obstetrics and Gynecology, Mbarara Regional Referral Hospital, Mbarara, Uganda.
J Matern Fetal Neonatal Med. 2025 Dec;38(1):2496394. doi: 10.1080/14767058.2025.2496394. Epub 2025 Apr 27.
Pre-eclampsia is a major cause of adverse perinatal outcomes, such as preterm birth and perinatal deaths, at Mbarara Regional Referral Hospital (MRRH). While serum uric acid is a crucial marker for predicting adverse outcomes, it is not routinely assessed. This study aimed to compare the incidence of adverse perinatal outcomes between women with and without hyperuricemia and determine the association between hyperuricemia and adverse perinatal outcomes among women with preeclampsia at MRRH.
We conducted a prospective cohort study from March 2024 to June 2024 at the maternity ward of MRRH. We consecutively enrolled women diagnosed with preeclampsia who were at least 26 weeks gestational age and assessed their serum uric acid levels upon admission. The primary exposure was hyperuricemia (>6mg/dl) while the primary outcome was adverse perinatal outcomes. We compared the incidence of adverse perinatal outcomes among those with and without hyperuricemia using Chi-square and used multivariable modified Poisson regression analysis to determine the association between hyperuricemia and adverse perinatal outcomes among women with preeclampsia.
Among the 111 women enrolled (mean age 28.3 ± 6.5 years), 43 (38.7%) had hyperuricemia. Adverse perinatal outcomes occurred in 55.9% (62/111). Women with hyperuricemia had higher rates of adverse outcomes (88%, = 38/43) than those without (35%, = 24/68). Specific outcomes were significantly more frequent among hyperuricemic women: fresh stillbirth (21% vs. 0%), low birth weight (49% vs. 26%), Apgar score <7 at 5 min (26% vs. 1%), NICU admission (76% vs. 26%), and early neonatal death (32% vs. 0%), < 0.05. Hyperuricemia was linked to a two-fold increased risk of one or more adverse outcomes (aRR 2.42, 95% CI: 1.54-3.80), fresh stillbirth (aRR 3.14, 95% CI: 1.79-5.48), low Apgar score (aRR 31.5, 95% CI: 3.8-260.9), NICU admission (aRR 2.44, 95% CI: 1.86-4.49), and early neonatal death (aRR 12.1, 95% CI: 4.22-33.98).
Hyperuricemia is common in preeclamptic women at MRRH and is associated with significantly higher rates of complications. Routine serum uric acid testing is recommended for early detection and timely intervention to improve maternal and neonatal health outcomes.
在姆巴拉拉地区转诊医院（MRRH），子痫前期是围产期不良结局（如早产和围产期死亡）的主要原因。虽然血清尿酸是预测不良结局的关键指标，但并未常规进行评估。本研究旨在比较高尿酸血症患者和非高尿酸血症患者围产期不良结局的发生率，并确定MRRH子痫前期患者中高尿酸血症与围产期不良结局之间的关联。
我们于2024年3月至2024年6月在MRRH的产科病房进行了一项前瞻性队列研究。我们连续纳入诊断为子痫前期且孕周至少26周的女性，并在入院时评估她们的血清尿酸水平。主要暴露因素为高尿酸血症（>6mg/dl），主要结局为围产期不良结局。我们使用卡方检验比较高尿酸血症患者和非高尿酸血症患者围产期不良结局的发生率，并使用多变量修正泊松回归分析来确定子痫前期患者中高尿酸血症与围产期不良结局之间的关联。
在纳入的111名女性（平均年龄28.3±6.5岁）中，43名（38.7%）患有高尿酸血症。围产期不良结局发生率为55.9%（62/111）。高尿酸血症女性的不良结局发生率（88%，38/43）高于非高尿酸血症女性（35%，24/68）。高尿酸血症女性的特定结局明显更频繁：新鲜死产（21%对0%）、低出生体重（49%对26%）、5分钟时阿氏评分<7（26%对1%）、入住新生儿重症监护病房（NICU，76%对26%）和早期新生儿死亡（32%对0%），P<0.05。高尿酸血症与一种或多种不良结局风险增加两倍相关（调整风险比[aRR]2.42，95%置信区间[CI]：1.54-3.80）、新鲜死产（aRR 3.14，95%CI：1.79-5.48）、低阿氏评分（aRR 31.5，95%CI：3.8-260.9）、入住NICU（aRR 2.44，95%CI：1.86-4.49）和早期新生儿死亡（aRR 12.1，95%CI：4.22-33.98）。
在MRRH的子痫前期女性中，高尿酸血症很常见，且与明显更高的并发症发生率相关。建议进行常规血清尿酸检测以早期发现并及时干预，以改善母婴健康结局。
