Maternal Serum Uric Acid Levels and Adverse Pregnancy Outcomes in Women with Hypertensive Disorders of Pregnancy

Abstract

Introduction: Hypertensive Disorders of Pregnancy (HDP) are the major cause of maternal morbidity and mortality worldwide. The maximum burden of maternal mortality and morbidity is due to HDP and its related complications which is further followed by obstetric haemorrhage, pre-existing medical diseases, infections and abortions. Aim: To study the association between the serum uric acid level in hypertensive pregnant women and their association with maternal and foetal morbidity and mortality. Materials and Methods: It was a prospective observational study conducted at BLDE (Deemed to be) University, Shri BM Patil Medical College Hospital and Research Centre, Vijayapura, Karnataka, India from January to June 2019. A total of 165 pregnant women with HDP were included (44 (27%) had Gestational Hypertension (GH); 86 (52%), Pre-eclampsia (PE) and 35 (21%) eclampsia) in each group in the study and they were subjected for obstetric history, examination and laboratory evaluation. The laboratory evaluation included complete blood count, liver function test, renal function test, serum uric acid level and urine albumin, sugars and microscopy. The maternal and foetal outcomes were measured, which included mode of delivery, Neonatal Intensive Care Unit (NICU) admission, neonatal outcomes in terms of preterm or term delivery, intrauterine death, fresh still born, neonatal deaths. Results: A total of 165 cases with HDP were enrolled in the study. Mean serum uric acid level in GH, PE and eclampsia group was 5.13±1.32, 5.34±1.4, 6.05±1.67, respectively. A total of 118 participants presented at term and 47 were preterm (11 in GH, 20 in PE and 16 in eclampsia group). About 103 (62.42%) had vaginal delivery and 62 (31.51%) underwent caesarean section (14 in GH, 28 in PE and 20 in eclampsia group). All the perinatal deaths occurred were in women with PE (n=5) and eclampsia (n=2) and was not statistically analysed. Conclusion: Present study shows that increased levels of maternal serum uric acid levels were associated with PE and eclampsia compared to GH patients and were associated with adverse foetal outcomes and increase in the instrumental and operative interventions.