Combination of lipids and uric acid in mid-second trimester can be used to predict adverse pregnancy outcomes.
OBJECTIVE
The objective of this study was to evaluate the predictive values of lipids and uric acid in mid-second trimester for adverse pregnancy outcome.


METHODS
Lipids and uric acid concentrations were measured in 1000 healthy nulliparous women at 20 weeks of gestation. Pregnancy outcomes were followed-up. The odds ratios (OR) and 95% CI were estimated with unconditional logistic regression adjusting for maternal age and body mass index (BMI).


RESULTS
Women who had elevated triglyceride (TG) in the mid-second trimester experienced a 2.91-fold risk (95% CI 1.58-5.34) for preeclampsia and a 2.03-fold risk (95% CI 1.29-3.19) for gestation diabetes mellitus (GDM). Hyperuricemic women experienced a 1.99-fold risk (95% CI 1.16-3.40) for preeclampsia and a 2.34-fold risk (95% CI 1.44-3.83) for GDM, while women who had decreased high-density lipoprotein cholesterol (HDLc) experienced a 2.32-fold risk (95% CI 1.18-4.58) for preeclampsia, a 2.11-fold risk (95% CI 1.37-3.25) for GDM, and a 1.63-fold risk (95% CI 1.02-2.60) for delivering macrosomic newborns. These effects were concentration dependent, as risks increased with increasing TG quartiles and with decreasing HDLc quartiles. The result of the ROC analysis revealed that the sensitivity and specificity values for one marker alone was relatively low. But when combined TG, HDLc, uric acid, age and BMI together, the area under ROC curve increased to 0.71-0.77, sensitivity and specificity increased to 80-92% and 50-53%.


CONCLUSIONS
The combination of these metabolic markers in mid-second trimester can be used to predict adverse pregnancy outcomes.
Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China.
Jianjun
J
Zhou
Xia
X
Zhao
Zhiqun
Z
Wang
Yali
Y
Hu
D000328:Adult; D016640:Diabetes, Gestational / Q000097:blood / Q000175:diagnosis; D005260:Female; D006801:Humans; D008055:Lipids / Q000032:analysis / Q000097:blood*; D008137:Longitudinal Studies; D011225:Pre-Eclampsia / Q000097:blood / Q000175:diagnosis; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000175:diagnosis*; D011256:Pregnancy Outcome / Q000453:epidemiology; D011262:Pregnancy Trimester, Second / Q000097:blood*; D011379:Prognosis; D014527:Uric Acid / Q000032:analysis / Q000097:blood*; D055815:Young Adult
D008055:Lipids; D014527:Uric Acid