Uric acid levels in gestational hypertensive women predict preeclampsia and outcome of small-for-gestational-age infants

Abstract

Objective

This study aims to ascertain whether serum uric acid is a suitable predictor of preeclampsia and/or the delivery of small-for-gestational-age infants for women with gestational hypertension.

Methods

364 singleton pregnant women with initial presentation of gestational hypertension were recruited and followed up until 6 weeks after delivery. Uric acid z score and binary logistic regression analysis were applied to establish the relationship between serum uric acid and the chance of progression to preeclampsia and giving birth to a small-for-gestational-age infant. Furthermore, receiver operating characteristic (ROC) analysis was used to evaluate the prediction value of serum uric acid.

Results

Uric acid z score and binary logistic regression analysis indicated that elevated serum uric acid increased the chances of gestational hypertension progression to preeclampsia and subsequent delivery of small-for-gestational-age infants. ROC analysis showed that serum uric acid at a cutoff value of 303μmol l-1, moderately predict the development of preeclampsia and the delivery of small-for-gestational age infants. The prediction values of preeclampsia were 90.7% sensitivity, 69.4% specificity, 97.7% negative predictor values and 34.0% positive predictor values, comparatively, the prediction value for small-for-gestational age infant was low. The ROC curve improved with 95.8% sensitivity, 86.7% specificity, 98.1% NPV, and 74.2% PPV in the Chinese Han women with early onset of gestational hypertension thus the diagnosis of gestational hypertension before 34 weeks.

Conclusions

Elevated serum uric acid in Chinese Han women with gestational hypertension indicated an increased risk of their progression to preeclampsia and the further delivering of small-for-gestational-age infants.

Keywords:

• Gestational hypertension
• preeclampsia
• small for gestational age
• uric acid

Acknowledgements

Thanks to Ms. Shen Jiali M.D. for her excellent technical assistance as well as the study participants for their cooperation.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Key Disciplines Group Construction Project of Pudong Health Bureau of Shanghai under Grant [No.PWZxq2014-02] and the Shanghai Municipal Medical and Health Discipline Construction Projects under grant [No. 2017ZZ02015]. The funders had no role in study design, data collection, analysis or decision to publish.