Uric Acid as a predictor of adverse maternal and perinatal outcomes in women hospitalized with preeclampsia.
OBJECTIVE
Elevated serum uric acid is commonly observed in women with preeclampsia, but its utility in predicting adverse outcomes has recently been disputed. Our goal was to analyze data from a large cohort of women with preeclampsia to determine the utility of serum uric acid in predicting adverse maternal and perinatal outcomes.


METHODS
Data were obtained from an ongoing international prospective study of women admitted to hospital with preeclampsia (Pre-eclampsia Integrated Estimate of RiSk). Univariate logistic regression was used to determine the relationship between serum uric acid concentration (both absolute and gestational-age corrected [Z score]) and adverse outcomes (maternal and perinatal). Analyses were conducted to compare cohorts of women with preeclampsia as defined by hypertension and proteinuria versus hypertension and hyperuricemia.


RESULTS
Uric acid Z score was associated with adverse perinatal outcome (OR 1.5; 95% CI 1.4 to 1.7) and had a point estimate > 0.7 (area under the curve receiver operating characteristic 0.72; 95% CI 0.69 to 0.74). Serum uric acid concentration also showed a significant association with adverse maternal outcomes, but the point estimate was < 0.7. No significant differences were observed between groups in which preeclampsia was defined by hypertension and proteinuria and by hypertension and hyperuricemia.


CONCLUSIONS
In women admitted to hospital with preeclampsia, the serum uric acid concentration, corrected for gestational age via a Z score, is clinically useful in predicting adverse perinatal outcomes but not maternal outcomes.
Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC; The CFRI Reproduction and Healthy Pregnancy Cluster, University of British Columbia, Vancouver BC.
Joel R
JR
Livingston
Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC; The CFRI Reproduction and Healthy Pregnancy Cluster, University of British Columbia, Vancouver BC.
Beth
B
Payne
Department of Renal Medicine, St. George Hospital Kogarah and University of NSW, Sydney Australia.
Mark
M
Brown
Department of Obstetrics, Gynaecology and Reproductive Sciences, Magee-Womens Research Institute and University of Pittsburgh, Pittsburgh PA.
James M
JM
Roberts
Department of Medicine, Université de Sherbrooke, Sherbrooke QC.
Anne-Marie
AM
Côté
Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC; The CFRI Reproduction and Healthy Pregnancy Cluster, University of British Columbia, Vancouver BC.
Laura A
LA
Magee
Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC; The CFRI Reproduction and Healthy Pregnancy Cluster, University of British Columbia, Vancouver BC; School of Population and Public Health, University of British Columbia, Vancouver BC.
Peter
P
von Dadelszen
D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D011225:Pre-Eclampsia / Q000097:blood*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D012307:Risk Factors; D014527:Uric Acid / Q000097:blood*
D014527:Uric Acid
preeclampsia; pregnancy outcome; risk assessment; uric acid