Abstract
Objectives To compare serum uric acid levels with disease severity and perinatal outcome among preeclamptic and normal pregnant women. Materials and Methods This was a case-control study carried out in Federal Medical Centre, Umuahia, Nigeria. Consenting pregnant women were consecutively recruited into two groups comprising pregnant women diagnosed with preeclampsia and normotensive nonproteinuric pregnant women. Exclusion criteria included pregnant women who were current smokers, took alcohol, and diagnosed with multiple gestation, diabetes mellitus, or renal failure. Associations between categorical variables such as preeclampsia severity and perinatal outcomes were done using logistic regression while means of continuous variables such as serum uric acid were compared using Student's t-test. Data were presented using odds ratios (ORs) with 95% confidence intervals (95% CI) and a statistical significance level set at P value ˂ 0.05. Data analysis was done using Statistical Package for Social Sciences version 22. Results One hundred and two participants were finally analysed. Fifty-one participants were recruited in each arm. Women with preeclampsia had significantly high serum uric acid level versus controls (6.08 ± 0.49 mg/dL vs. 5.20 ± 0.19; P < 0.001). Women with elevated serum uric acid levels (˃6 mg/dL) were found to be 4 times more likely to have severe preeclampsia (P=0.022, OR = 4.00, 95% CI = 1.225–13.056), 66 times more likely to have APGAR score ˂7 in the first minute (P < 0.001, OR = 66.00, 95% CI = 6.991–623.128), and 3 times more likely to have lower birth weight (P=0.038, OR = 3.400, 95% CI = 1.073–10.775) than those with normal serum uric acid levels. Conclusions The mean serum uric acid level in a preeclamptic is higher than that of normal pregnant control, and higher levels are associated with severity of the disease and significantly associated with poorer perinatal outcome.
Highlights
One hundred and forty-nine participants were initially approached and screened for inclusion in the study, following which 31.54% of the participants were excluded while one hundred and two participants were recruited. e flowchart of the participants is shown in Figure 1. ey were categorized into two groups: group A which comprised 51 pregnant women diagnosed with preeclampsia and group B
Women with preeclampsia had significantly high serum uric acid level compared to controls
Our findings showed that 59.0% of those that were diagnosed with preeclampsia had severe preeclampsia and that 53.0% of the preeclamptics had abnormal uric acid (>6 mg/dL)
Summary
Preeclampsia affects approximately 5–7% of all pregnancies and is associated with several complications [2]. In developing countries where access to health care is limited, preeclampsia is a leading cause of maternal mortality, causing an estimated >50,000 maternal deaths per year [6]. While maternal death due to preeclampsia is less common in developed countries, maternal morbidity is high and is a major contributor to intensive care unit admissions during pregnancy [7]. 12 to 25% of fetal growth restriction and Obstetrics and Gynecology International small for gestation age infants as well as 15 to 20% of all preterm births are attributable to preeclampsia; the associated complications of prematurity are substantial including neonatal deaths and serious long-term neonatal morbidity [8]. The etiology is still largely unknown, there are a few hypotheses regarding the pathophysiology and prediction of preeclampsia [9,10,11]
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