Gestational hyperuricemia

Abstract

Serum uric acid (SUA) is the end product of nuclear cell metabolism. In physiological concentration of SUA has a positive effect on human body. With the improvement of living standards and lifestyle changes of Chinese people, the incidence of hyperuricemia (HUA) has been increasing, leading to a rise in the incidence of gout, hypertension, cardiovascular disease and kidney disease. In physiological condition, the formation and excretion of uric acid are relatively stable. During the first trimester of pregnancy, uric acid excretion increases, subsequently SUA concentration decreases. During the second and third trimester of pregnancy, as the fetus excreting more uric acid through amniotic fluid, the decreasing of kidney′s ability to remove uric acid, and the changes of internal environment and diet of pregnant women, the SUA concentration gradually increases. During pregnancy, elevated SUA is often associated with multiple pregnancy-related diseases, such as hypertensive disorder complicating pregnancy, gestational diabetes mellitus (GDM), and they interact with each other. In addition, gestational HUA can affect fetal growth and development. High concentration of SUA can be used as a biological marker for early diagnosis of adolescent depression, which may related to HUA can lead to the DNA oxidative damage of neurons. The diagnosis of gestational HUA should be based on the dynamic changes of SUA during pregnancy, rather than the diagnosis criteria of adult HUA. Present medicines to prevent the synthesis of uric acid, or promote uric acid excretion and analgesics have certain potential risks to pregnant women with gestational HUA and fetus. Therefore, appropriate alkalize urine, drinking abundant water, promoting urination, low purine diet, weight control, quitting smoking, and alcohol restriction are feasible and safe to prevent and treat HUA during perinatal period. Key words: Hyperuricemia; Uric acid; Hypertension, pregnancy-induced; Diabetes, gestational; Pregnant women