Uric acid levels in gestational hypertensive women predict preeclampsia and outcome of small-for-gestational-age infants

Objective This study aims to ascertain whether serum uric acid is a suitable predictor of preeclampsia and/or the delivery of small-for-gestational-age infants for women with gestational hypertension. Methods 364 singleton pregnant women with initial presentation of gestational hypertension were recruited and followed up until 6 weeks after delivery. Uric acid z score and binary logistic regression analysis were applied to establish the relationship between serum uric acid and the chance of progression to preeclampsia and giving birth to a small-for-gestational-age infant. Furthermore, receiver operating characteristic (ROC) analysis was used to evaluate the prediction value of serum uric acid. Results Uric acid z score and binary logistic regression analysis indicated that elevated serum uric acid increased the chances of gestational hypertension progression to preeclampsia and subsequent delivery of small-for-gestational-age infants. ROC analysis showed that serum uric acid at a cutoff value of 303 mu mol l-1, moderately predict the development of preeclampsia and the delivery of small-for-gestational age infants. The prediction values of preeclampsia were 90.7% sensitivity, 69.4% specificity, 97.7% negative predictor values and 34.0% positive predictor values, comparatively, the prediction value for small-for-gestational age infant was low. The ROC curve improved with 95.8% sensitivity, 86.7% specificity, 98.1% NPV, and 74.2% PPV in the Chinese Han women with early onset of gestational hypertension thus the diagnosis of gestational hypertension before 34 weeks. Conclusions Elevated serum uric acid in Chinese Han women with gestational hypertension indicated an increased risk of their progression to preeclampsia and the further delivering of small-for-gestational-age infants.

Automated summary

The study found that elevated serum uric acid in Chinese Han women with gestational hypertension is associated with an increased risk of progression to preeclampsia and delivering small-for-gestational-age infants. ROC analysis showed moderate prediction values for preeclampsia, but relatively low prediction values for small-for-gestational-age infants, with improved accuracy in Han women with early onset gestational hypertension.