title: Plasma uric acid remains a marker of poor outcome in hypertensive pregnancy: a retrospective cohort study.
abstract: OBJECTIVE
  To examine the relationship between hyperuricaemia, haemoconcentration and maternal and fetal outcomes in hypertensive pregnancies.
  
  
  METHODS
  Retrospective analysis of a database of hypertensive pregnancies.
  
  
  METHODS
  St George Hospital, a major obstetric unit in Australia.
  
  
  METHODS
  A cohort of 1880 pregnant women without underlying hypertension or renal disease, referred for management of pre-eclampsia or gestational hypertension.
  
  
  METHODS
  Demographic, clinical and biochemical data at time of referral and delivery were collected for each pregnancy. Women were grouped according to diagnosis (pre-eclampsia or gestational hypertension) and logistic regression analysis was used to determine the relationship between uric acid, haemoglobin, haematocrit and adverse outcomes; an α level of P < 0.01 was used for statistical significance.
  
  
  METHODS
  Composites of adverse maternal and fetal outcomes.
  
  
  RESULTS
  In women with 'benign' GH (without proteinuria or any other maternal clinical feature of pre-eclampsia) gestation-corrected hyperuricaemia was associated with increased risk of a small-for-gestational-age infant (OR 2.5; 95% CI 1.3-4.8) and prematurity (OR 3.2; 95% CI 1.4-7.2), but not with adverse maternal outcome. In the whole cohort of hypertensive pregnant women (those with pre-eclampsia or gestational hypertension) the risk of adverse maternal outcome (OR 2.0; 95% CI 1.6-2.4) and adverse fetal outcome (OR 1.8; 95% CI 1.5-2.1) increased with increasing concentration of uric acid. Hyperuricaemia corrected for gestation provided additional strength to these associations. Haemoglobin and haematocrit were not associated with adverse pregnancy outcome.
  
  
  CONCLUSIONS
  Hyperuricaemia in hypertensive pregnancy remains an important finding because it identifies women at increased risk of adverse maternal and particularly fetal outcome; the latter, even in women with gestational hypertension without any other feature of pre-eclampsia.
authors.affiliation: Department of Medicine, University of Calgary, Alberta, Canada.
authors.forename: T L-A
authors.initials: TL
authors.lastname: Hawkins
authors.forename: J M
authors.initials: JM
authors.lastname: Roberts
authors.forename: G J
authors.initials: GJ
authors.lastname: Mangos
authors.forename: G K
authors.initials: GK
authors.lastname: Davis
authors.forename: L M
authors.initials: LM
authors.lastname: Roberts
authors.forename: M A
authors.initials: MA
authors.lastname: Brown
mesh_terms: D000328:Adult; D000465:Algorithms; D000975:Antioxidants / Q000378:metabolism*; D001315:Australia / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D005260:Female; D006400:Hematocrit; D006454:Hemoglobins; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D033461:Hyperuricemia / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D007231:Infant, Newborn; D007234:Infant, Premature; D007236:Infant, Small for Gestational Age / Q000097:blood; D016015:Logistic Models; D011225:Pre-Eclampsia / Q000097:blood; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000097:blood / Q000209:etiology; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014527:Uric Acid / Q000097:blood*
chemical_list: D000975:Antioxidants; D015415:Biomarkers; D006454:Hemoglobins; D014527:Uric Acid