Combination of lipids and uric acid in mid-second trimester can be used to predict adverse pregnancy outcomes

Abstract

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%. Conclusion: The combination of these metabolic markers in mid-second trimester can be used to predict adverse pregnancy outcomes.

Keywords::

• Lipid
• uric acid
• metabolic markers
• adverse pregnancy outcomes

Acknowledgments

We thank the nurses and doctors of Nanjing Drum Tower Hospital for sample collection, Biyun Xu for statistical assistance, and Yihua Zhou for linguistic assistance.

Declaration of Interest: This study was supported by Nanjing Medical Science and technique Development Foundation and Maternal and fetus medicine Key Lab of Jiangsu Province (XK 201102), Chinese National Natural Science Foundation (81070508). None of the authors has a conflict of interest.