title: Hyperuricemia facilitates the prediction of maternal and perinatal adverse outcome in patients with severe/superimposed preeclampsia.
abstract: OBJECTIVE
  Hyperuricemia has received much attention and debate recently with regard to its utility as a marker for preeclampsia and as a predictor of adverse maternal-fetal outcome. This investigation was undertaken in patients with severe/superimposed preeclampsia to determine whether the maternal uric acid (UA) level at initial hospital admission is a useful predictor of subsequent adverse maternal and/or perinatal outcomes.
  
  
  METHODS
  Retrospective analysis of all patients diagnosed with severe preeclampsia, superimposed preeclampsia or HELLP syndrome during 2005 at the University of Mississippi Medical Center (UMMC). Clinical and laboratory data were collected, entered and stored electronically in a password protected, secure system.
  
  
  RESULTS
  Adverse maternal outcomes occurred in 15.3% of 258 patients in the cohort. Mean UA concentration in the absence of adverse maternal outcomes was 342.6 ± 77.3 compared to 396.1 ± 117.2 μmol/l in pregnancies with complications (p<0.001). The positive likelihood ratio (LR) for adverse maternal outcome was 5.3 with UA ≥ 76.3 μmol/l and creatinine ≥ 1.0 mg/dl. LRs rose in association with other abnormal preeclampsia serum markers. Adverse perinatal outcomes occurred in 45.2% of births. The LRs for adverse perinatal outcomes remained unchanged around 1.0. Mean UA was 363.4 ± 91.0 compared to 339.0 ± 80.9 μmol/l in pregnancies without adverse outcomes (p=0.021).
  
  
  CONCLUSIONS
  Maternal hyperuricemia is a better predictor of maternal than perinatal risk and adverse outcome.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Winfred L. Wiser Hospital for Women and Infants, University of Mississippi Medical Center, Jackson, MS 39216-4505, USA. marc7parrish@hotmail.com
authors.forename: Marc
authors.initials: M
authors.lastname: Parrish
authors.forename: Meredith
authors.initials: M
authors.lastname: Griffin
authors.forename: Racheal
authors.initials: R
authors.lastname: Morris
authors.forename: Marie
authors.initials: M
authors.lastname: Darby
authors.forename: Michelle Y
authors.initials: MY
authors.lastname: Owens
authors.forename: James N
authors.initials: JN
authors.lastname: Martin
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D005260:Female; D005865:Gestational Age; D017359:HELLP Syndrome / Q000097:blood; D006801:Humans; D033461:Hyperuricemia / Q000150:complications*; D007226:Infant Mortality; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology; D016013:Likelihood Functions; D011225:Pre-Eclampsia / Q000097:blood*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D050497:Stillbirth / Q000453:epidemiology
chemical_list: D015415:Biomarkers