Prediction of preeclampsia incidence by measuring serum uric acid levels in patients with gestational hypertension

Abstract

Introduction: Some studies have pointed to the predictive role of high uric acid levels and the occurrence of preeclampsia; however, the finding in this field are still controversial and the appropriate level has not been determined. Objectives: The aim of present study was to investigate the relationship between serum uric acid level and preeclampsia occurrence and also determine the appropriate predictive level in patients with gestational hypertension (GHTN). Methods: At this prospective cohort study, the serum uric acid levels of 168 singleton pregnant women at the time of diagnosis of GHTN were measured and the patients were followed up until delivery. At the time of delivery, their uric acid levels were re-measured and symptoms of preeclampsia and eclampsia and neonatal outcomes were recorded. Results: Preeclampsia and eclampsia occurred in 126 (75%) and five of the patients (3%), respectively. Patients with preeclampsia/eclampsia had higher age and body mass index, most of them were primiparous, and had a history of miscarriage. Moreover, their gestational age at the time of diagnosis of GHTN was significantly lower (P<0.05). Treatment of hypertension was also significantly more prevalent in the preeclampsia/eclampsia group (P<0.001). The level of uric acid at the time of diagnosis of GHTN and at the time of delivery in patients with preeclampsia/eclampsia was significantly higher. In addition, the rate of uric acid elevation during pregnancy in the preeclampsia/eclampsia group was significantly higher (P<0.001). In receiver operating characteristic analysis, the uric acid level of 4.65 mg/dL at the time of diagnosis of GHTN with a sensitivity of 96.9% and a specificity of 81.1%, and a diagnostic accuracy of 93.5% was a predictor of preeclampsia/eclampsia in patients with GHTN. Conclusion: Our findings showed that 78% of patients with GHTN eventually developed preeclampsia/eclampsia and had significantly higher levels of serum uric acid levels both at the time of diagnosis of GHTN and at delivery. A uric acid level of 4.65 mg/dL at the time of diagnosis of GHTN was considered a predictor of preeclampsia/ eclampsia in patients with GHTN.