title: Accuracy of serum uric acid determination in predicting pre-eclampsia: a systematic review.
abstract: BACKGROUND
  Pre-eclampsia is a leading cause of maternal and perinatal mortality and morbidity. Early prediction of pre-eclampsia may be used to target high-risk women for effective preventative treatments. Hyperuricemia is associated with pre-eclampsia and it has been tested in early pregnancy for its ability to predict the later onset of the disease.
  
  
  OBJECTIVE
  To systematically review the accuracy of determining serum uric acid before the 25th gestational week in predicting pre-eclampsia.
  
  
  METHODS
  We searched Medline, Embase, Cochrane Library, Medion, bibliographies of review articles and eligible primary studies, and contacted experts in the field. Language restrictions were not applied. Reviewers working independently selected studies, extracted data and assessed validity according to eight criteria. Sensitivities and specificities were plotted in a Receiver Operating Characteristic plot.
  
  
  RESULTS
  We identified five primary articles, with a total of 572 women, including 44 who developed pre-eclampsia. Study populations differed clinically, with incidences ranging from 3.4% to 40.1%. Sensitivity ranged from 0.0% to 55.6% and specificity ranged from 76.9% to 94.9%. Clinical heterogeneity and poor reporting precluded sensible pooling of data. In particular, consecutive entry of eligible women, blind assessment of the reference standard, and treatment to prevent pre-eclampsia were poorly reported.
  
  
  CONCLUSIONS
  Contrary to previous reviews, we conclude that there is currently insufficient evidence to draw firm conclusions about the accuracy of serum uric acid determination in predicting pre-eclampsia.
authors.affiliation: Department of General Practice, Academic Medical Center-University of Amsterdam, Amsterdam, The Netherlands. j.s.cnossen@amc.uva.nl
authors.forename: Jeltsje S
authors.initials: JS
authors.lastname: Cnossen
authors.forename: Hanna
authors.initials: H
authors.lastname: de Ruyter-Hanhijärvi
authors.forename: Joris A M
authors.initials: JA
authors.lastname: van der Post
authors.forename: Ben W J
authors.initials: BW
authors.lastname: Mol
authors.forename: Khalid S
authors.initials: KS
authors.lastname: Khan
authors.forename: Gerben
authors.initials: G
authors.lastname: ter Riet
mesh_terms: D005260:Female; D006801:Humans; D011225:Pre-Eclampsia / Q000097:blood* / Q000175:diagnosis; D011237:Predictive Value of Tests; D011247:Pregnancy; D014527:Uric Acid / Q000097:blood*
chemical_list: D014527:Uric Acid