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Predictive value of early pregnancy uric acid levels for adverse pregnancy outcomes

Qiaohong Lai(1), Xin Zhang(2),


(1) Department of Obstetrics, Xiaolan People’s Hospital of Zhongshan (The Fifth People’s Hospital of Zhongshan), Zhongshan,528415, China
(2) Department of Obstetrics, Xiaolan People’s Hospital of Zhongshan (The Fifth People’s Hospital of Zhongshan), Zhongshan,528415, China
Corresponding Author

Abstract


Elevated serum uric acid (SUA) levels in pregnancy are linked to adverse outcomes, including preterm birth, preeclampsia, and low birth weight. To assess the predictive value of SUA levels in early pregnancy for adverse pregnancy outcomes (APOs). A cohort of 4,240 pregnant women admitted for delivery from January 2021 to December 2022 was analyzed. APOs were compared between women with hyperuricemia (HUA) (UA > 360 μmol/L) and those without HUA. Logistic regression (LR) analysis was used to identify risk factors for APOs. Among the cohort, 295 women (6.9%) had HUA. Compared to the non-HUA group, the HUA group had a higher BMI (22.45 vs. 21.34), higher rates of hypertension (6.1% vs. 3.4%), preterm birth (10.2% vs. 6.3%), and low birth weight (10.2% vs. 5.9%). Multivariate LR analysis identified elevated UA levels, BMI, diabetes, and preeclampsia as significant risk factors for APOs. The optimal UA threshold for predicting preterm birth was 253.855 μmol/L (sensitivity: 71.4%, specificity: 55.2%). Early pregnancy SUA levels are predictive of adverse pregnancy outcomes, providing a foundation for potential clinical interventions. Given the moderate sensitivity and specificity of the identified SUA threshold for predicting preterm birth, further research is warranted to refine these values and establish their clinical implications in obstetric practice.

References


de Oliveira EP and Burini RC. High plasma uric acid

concentration: causes and consequences. Diabetol

Metab Syndr 2012; 4: 12.

Tangeras LH, Austdal M, Skrastad RB, Tangerås LH,

Austdal M, Skråstad RB, Salvesen KÅ, Austgulen R,

Bathen TF and Iversen AC. Distinct First Trimester

Cytokine Profiles for Gestational Hypertension and

Preeclampsia. Arterioscl Throm Vas 2015; 35(11):

-2485.

Pleskacova A, Bartakova V, Chalasova K, Pacal L, Kankova

K and Tomandl J. Uric Acid and Xanthine Levels in

Pregnancy Complicated by Gestational Diabetes

Mellitus-The Effect on Adverse Pregnancy

Outcomes. Int J Mol Sci 2018; 19(11): 3696.

Wu Y, Xiong X, Fraser WD and Luo ZC. Association of uric

acid with progression to preeclampsia and

development of adverse conditions in gestational

hypertensive pregnancies. Am J Hypertens 2012;

(6): 711-717.

Leng J, Wang L, Wang J, Li W, Liu H, Zhang S, Li L, Tian

H, Xun P, Yang X and Yu Z. Uric acid and diabetes

risk among Chinese women with a history of

gestational diabetes mellitus. Diabetes Res Clin Pr

; 134: 72-79.

Zhen H and Gui F. The role of hyperuricemia on vascular

endothelium dysfunction. Biomed Rep 2017; 7(4):

-330.

Wang SF, Shu L, Wang S, Wang XQ, Mu M, Hu CQ, Liu

KY, Zhao QH, Hu AL, Bo QL and Tao FB. Gender

difference in the association of hyperuricemia with

hypertension in a middle-aged Chinese population.

Blood Pressure 2014; 23(6): 339-344.

Wang J, Tan GJ, Han LN, Bai YY, He M and Liu HB. Novel

biomarkers for cardiovascular risk prediction. J

Geriatr Cardiol 2017; 14(2): 135-150.

Brien ME, Duval C, Palacios J, Boufaied I, Hudon-Thibeault

AA, Nadeau-Vallée M, Vaillancourt C, Sibley CP,

Abrahams VM, Jones RL and Girard S. Uric Acid

Crystals Induce Placental Inflammation and Alter

Trophoblast Function via an IL-1-Dependent

Pathway: Implications for Fetal Growth Restriction. J

Immunol 2017; 198(1): 443-451.

Murata M, Fukushima K, Takao T, Seki H, Takeda S and

Wake N. Oxidative stress produced by xanthine

oxidase induces apoptosis in human extravillous

trophoblast cells. J Reprod Develop 2013; 59(1): 7-

Pasalic D, Marinkovic N and Feher-Turkovic L. Uric acid

as one of the important factors in multifactorial

disorders--facts and controversies. Biochem Medica

; 22(1): 63-75.

Kang DH and Ha SK. Uric Acid Puzzle: Dual Role as Antioxidantand Pro-oxidant. Electrolyte Blood Press

; 12(1): 1-6.

Waring WS, Webb DJ and Maxwell SR. Systemic uric acid

administration increases serum antioxidant capacity

in healthy volunteers. J Cardiovasc Pharm 2001;

(3): 365-371.

Sharaf EDU, Salem MM and Abdulazim DO. Uric acid in

the pathogenesis of metabolic, renal, and

cardiovascular diseases: A review. J Adv Res 2017;

(5): 537-548.

Corry DB, Eslami P, Yamamoto K, Nyby MD, Makino H

and Tuck ML. Uric acid stimulates vascular smooth

muscle cell proliferation and oxidative stress via the

vascular renin-angiotensin system. J Hypertens 2008;

(2): 269-275.

Petrasek J, Iracheta-Vellve A and Saha B. Metabolic danger

signals, uric acid and ATP, mediate inflammatory

cross-talk between hepatocytes and immune cells in

alcoholic liver disease. J Leukocyte Biol 2015; 98(2):

-256.

Yu MA, Sanchez-Lozada LG, Johnson RJ and Kang DH.

Oxidative stress with an activation of the reninangiotensin system in human vascular endothelial

cells as a novel mechanism of uric acid-induced

endothelial dysfunction. J Hypertens 2010; 28(6):

-1242.

Sodhi K, Hilgefort J, Banks G, Gilliam C, Stevens S,

Ansinelli HA, Getty M, Abraham NG, Shapiro JI and

Khitan Z. Uric Acid-Induced Adipocyte Dysfunction

Is Attenuated by HO-1 Upregulation: Potential Role

of Antioxidant Therapy to Target Obesity. Stem Cells

Int 2016; 2016: 8197325.

Ryu ES, Kim MJ, Shin HS, Jang YH, Choi HS, Jo I, Johnson

RJ and Kang DH. Uric acid-induced phenotypic

transition of renal tubular cells as a novel mechanism

of chronic kidney disease. Am J Physiol-Renal 2013;

(5): F471-F480.

Bainbridge SA, von Versen-Hoynck F and Roberts JM. Uric

acid inhibits placental system A amino acid uptake.

Placenta 2009; 30(2): 195-200.

Bainbridge SA, Roberts JM, von Versen-Hoynck F, Koch

J, Edmunds L and Hubel CA. Uric acid attenuates

trophoblast invasion and integration into endothelial

cell monolayers. Am J Physiol-Cell Ph 2009; 297(2):

C440-C450.

Mulla MJ, Salmon JE, Chamley LW, Brosens JJ and Boeras

CM, Kavathas PB and Abrahams VM. A role for uric

acid and the Nalp3 inflammasome in

antiphospholipid antibody-induced IL-1beta

production by human first trimester trophoblast. Plos

One 2013; 8(6): e65237.

Owen JC, Garrick SP, Peterson BM, Berger PJ, Nold MF,

Sehgal A and Nold-Petry CA. The role of interleukin1 in perinatal inflammation and its impact on

transitional circulation. Front Pediatr 2023; 11:

Shirasuna K, Karasawa T and Takahashi M. Role of the

NLRP3 Inflammasome in Preeclampsia. Front

Endocrinol 2020; 11: 80.

Kanellis J, Watanabe S, Li JH, Kang DH, Li P, Nakagawa

T, Wamsley A, Sheikh-Hamad D, Lan HY, Feng L

and Johnson RJ. Uric acid stimulates monocyte

chemoattractant protein-1 production in vascular

smooth muscle cells via mitogen-activated protein

kinase and cyclooxygenase-2. Hypertension 2003;

(6): 1287-1293.

Cheung KL and Lafayette RA. Renal physiology of

pregnancy. Adv Chronic Kidney D 2013; 20(3): 209-

Hromadnikova I, Kotlabova K, Dvorakova L and Krofta L.

Maternal Cardiovascular Risk Assessment 3-to-11

Years Postpartum in Relation to Previous Occurrence

of Pregnancy-Related Complications. J Clin Med

; 8(4): 544.

Richette P, Doherty M, Pascual E, Barskova V, Becce F,

Castañeda-Sanabria J, Coyfish M, Guillo S, Jansen

TL, Janssens H and Lioté F. 2016 updated EULAR

evidence-based recommendations for the

management of gout. Ann Rheum Dis 2017; 76(1):

-42.

Cnossen JS, de Ruyter-Hanhijarvi H, van der Post JA, Mol

BW, Khan KS and ter Riet G. Accuracy of serum uric

acid determination in predicting pre-eclampsia: a

systematic review. Acta Obstet Gyn Scan 2006;

(5): 519-525.

Flint J, Panchal S, Hurrell A, van de Venne M, Gayed M,

Schreiber K, Arthanari S, Cunningham J, Flanders L,

Moore L and Crossley A. BSR and BHPR guideline

on prescribing drugs in pregnancy and breastfeedingPart I: standard and biologic disease modifying antirheumatic drugs and corticosteroids. Rheumatology

; 55(9): 1693-1697


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