Joel R Livingston1, Beth Payne1, Mark Brown2, James M Roberts3, Anne-Marie Côté4, Laura A Magee1, Peter von Dadelszen5. 1. Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC; The CFRI Reproduction and Healthy Pregnancy Cluster, University of British Columbia, Vancouver BC. 2. Department of Renal Medicine, St. George Hospital Kogarah and University of NSW, Sydney Australia. 3. Department of Obstetrics, Gynaecology and Reproductive Sciences, Magee-Womens Research Institute and University of Pittsburgh, Pittsburgh PA. 4. Department of Medicine, Université de Sherbrooke, Sherbrooke QC. 5. 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.
Abstract
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. CONCLUSION: 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.
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. CONCLUSION: 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.
Authors: Liona C Poon; Laura A Magee; Stefan Verlohren; Andrew Shennan; Peter von Dadelszen; Eyal Sheiner; Eran Hadar; Gerard Visser; Fabricio Da Silva Costa; Anil Kapur; Fionnuala McAuliffe; Amala Nazareth; Muna Tahlak; Anne B Kihara; Hema Divakar; H David McIntyre; Vincenzo Berghella; Huixia Yang; Roberto Romero; Kypros H Nicolaides; Nir Melamed; Moshe Hod Journal: Int J Gynaecol Obstet Date: 2021-07 Impact factor: 4.447
Authors: Tam M Le; Long H Nguyen; Nam L Phan; Duong D Le; Huy V Q Nguyen; Vinh Q Truong; Thanh N Cao Journal: Int J Gynaecol Obstet Date: 2018-11-08 Impact factor: 3.561
Authors: Peter von Dadelszen; Meriel Flint-O'Kane; Lucilla Poston; Rachel Craik; Donna Russell; Rachel M Tribe; Umberto d'Alessandro; Anna Roca; Hawanatu Jah; Marleen Temmerman; Angela Koech Etyang; Esperança Sevene; Paulo Chin; Joy E Lawn; Hannah Blencowe; Jane Sandall; Tatiana T Salisbury; Benjamin Barratt; Andrew H Shennan; Prestige Tatenda Makanga; Laura A Magee Journal: Reprod Health Date: 2020-04-30 Impact factor: 3.223