Predictive value of serum uric acid levels for adverse perinatal outcomes in preeclampsia

Abstract

Preeclampsia is a multisystem disorder associated with pregnancy and is a common cause of perinatal morbidity. The aim of this study was to determine whether elevated serum uric acid levels, alone or in combination with other laboratory factors could predict preeclampsia in women with adverse perinatal outcomes. We conducted a prospective observational study of women who were admitted to Soonchunhyang University Cheonan Hospital from January 2016 to December 2016. Demographic, clinical and laboratory data were collected for each pregnancy at the time of delivery. Women were grouped according to status (preeclampsia or normotensive), and a logistic regression analysis was used to determine the relationship between serum uric acid levels and adverse outcomes. The mean age of the study participants was 31.3 ± 5.0 years. In patients with preeclampsia, serum uric acid level was associated with the severity of preeclampsia, including blood pressure ( R = 0.321, P = .014), serum creatinine levels ( R = 0.505, P < .001), and proteinuria ( P = .014), as well as adverse fetal outcomes, including preterm labor ( P = .027) and low birth weight delivery ( P = .001). The optimal maternal serum uric acid threshold that predicted low birth weight at delivery was 6.35 mg/dL (sensitivity, 0.58; specificity, 0.95). The multivariable logistic regression model that was used to predict low birth weight at delivery displayed an area under the receiver-operating characteristic curve of 0.902 (95% confidence interval, 0.817–0.986). In women with preeclampsia, maternal serum uric acid level is an important parameter for predicting low birth weight. Additionally, the combination of uric acid, hemoglobin, and bilirubin levels appear to be optimal for predicting low birth weight in women with preeclampsia.

Comparison of Multivariable Logistic Regression and Other Machine Learning Algorithms for Prognostic Prediction Studies in Pregnancy Care: Systematic Review and Meta-Analysis

“…Only a few studies had prediction timing up to the puerperal or neonatal period for LR (2/77, 3%) [74,85], non-LR (3/50, 6%) [114,129,149], or both algorithms (2/15, 13%) [162,168]. This is because some predictors were assessed after delivery, whereas our review question demanded those be assessed up to delivery.…”

Association of serum uric acid and serum lipid profile in pre- eclampsia- A hospital based case-control study

“…If 24-hour urine collec on is not available, then proteinuria is defined as a concentra on of at least 30 mg/dL in at least two random urine samples 2 collected at least 6 hours apart. Preeclampsia is one of the most common complica on during pregnancy affec ng 2-8% of all the pregnancies resul ng in considerable maternal 3,4 and fetal morbidity and mortality. It is believed to be due to subop mal uteroplacental perfusion associated with maternal inflammatory response and maternal vascular 4 endothelial dysfunc on.…”

Clinical significance of microRNA-320a and insulin-like growth factor-1 receptor in early-onset preeclampsia patients

“…In support of these, a previous study has provided evidence that miR-320a is abnormally enhanced in PE patients, promising to be a therapeutic target for PE therapy [22]. It is well established that increased urinary protein excretion, MAP, UA and SCR levels during pregnancy are potent indexes for EOPE prediction [23][24][25][26]. In addition, decreased platelet count and ALB level also show a predictive and diagnostic value for EOPE [27,28].…”