Volume 15, Issue 9 (9-2017)
IJRM 2017, 15(9): 583-588 |
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Maryam Asgharnia1 
, Fariba Mirblouk1 , Soudabeh Kazemi * 2, Davood Pourmarzi1 , Mina Mahdipour Keivani3 , Seyedeh Fatemeh Dalil Heirati1
, Fariba Mirblouk1 , Soudabeh Kazemi * 2, Davood Pourmarzi1 , Mina Mahdipour Keivani3 , Seyedeh Fatemeh Dalil Heirati1
1- Reproductive Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
2- Reproductive Health Research Center, Guilan University of Medical Sciences, Rasht, Iran , drsodabehkazemi@gmail.com
3- Guilan University of Medical Sciences, Rasht, Iran.
2- Reproductive Health Research Center, Guilan University of Medical Sciences, Rasht, Iran , drsodabehkazemi@gmail.com
3- Guilan University of Medical Sciences, Rasht, Iran.
Abstract: (11108 Views)
Background: Preeclampsia is associated with maternal and neonatal complications. It has been indicated that increased uric acid might have a predictive role on preeclampsia.
Objective: We aimed to investigate the relationship between the level of uric acid with maternal and neonatal complications in women with preeclampsia.
Materials and Methods: In this cross-sectional study, 160 singleton preeclamptic women at more than 28 wk gestational age were included. Hemoglobin, hematocrit, platelet count, liver and uric acid tests, and maternal and neonatal complications were assessed. The severity of preeclampsia, placental abruption, preterm labor, thrombocytopenia, elevated alanine aminotransferase and aspartate aminotransferase (ALT and AST), HELLP syndrome, eclampsia and required hospitalization in the ICU was considered as the maternal complication. Fetal complications were: small for gestational age (SGA), intrauterine fetal death, hospitalization in the neonatal intensive care unit, and Apgar score <7 at five minutes.
Results: Of our participants, 38 women had severe preeclampsia (23.8%). The mean level of uric acid in women with severe preeclampsia was significantly higher than non-severe preeclampsia (p=0.031), also in those with an abnormal liver test (p=0.009). The mean level of uric acid in women with preterm delivery was significantly higher than women with term delivery (p=0.0001). Also, the level of uric acid had no effect on neonatal hospitalization in neonate invasive care unit. Based on logistic regression, the incidence of severe preeclampsia not affected by decreased or increased serum levels of uric acid.
Conclusion: With higher level of uric acid in server preeclampsia we can expected more complications such as hepatic dysfunction and preterm delivery. Thus serum uric acid measurement can be helpful marker for severe preeclampsia.
Objective: We aimed to investigate the relationship between the level of uric acid with maternal and neonatal complications in women with preeclampsia.
Materials and Methods: In this cross-sectional study, 160 singleton preeclamptic women at more than 28 wk gestational age were included. Hemoglobin, hematocrit, platelet count, liver and uric acid tests, and maternal and neonatal complications were assessed. The severity of preeclampsia, placental abruption, preterm labor, thrombocytopenia, elevated alanine aminotransferase and aspartate aminotransferase (ALT and AST), HELLP syndrome, eclampsia and required hospitalization in the ICU was considered as the maternal complication. Fetal complications were: small for gestational age (SGA), intrauterine fetal death, hospitalization in the neonatal intensive care unit, and Apgar score <7 at five minutes.
Results: Of our participants, 38 women had severe preeclampsia (23.8%). The mean level of uric acid in women with severe preeclampsia was significantly higher than non-severe preeclampsia (p=0.031), also in those with an abnormal liver test (p=0.009). The mean level of uric acid in women with preterm delivery was significantly higher than women with term delivery (p=0.0001). Also, the level of uric acid had no effect on neonatal hospitalization in neonate invasive care unit. Based on logistic regression, the incidence of severe preeclampsia not affected by decreased or increased serum levels of uric acid.
Conclusion: With higher level of uric acid in server preeclampsia we can expected more complications such as hepatic dysfunction and preterm delivery. Thus serum uric acid measurement can be helpful marker for severe preeclampsia.
Type of Study: Original Article |
References
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2. Gary cunningham Jk, al Le. Williams Obstetrics. United States of America, Mc Graw-Hill Companies; 2014: 746-750.
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6. Macdonald-Wallis C, Lawlor DA, Fraser A, May M, Nelson SM, Tilling K. Blood pressure change in normotensive, gestational hypertensive, preeclamptic, and essential hypertensive pregnancies. Hypertension 2012; 59: 1241-1248. [DOI:10.1161/HYPERTENSIONAHA.111.187039]
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9. Bargale A, GAnu JV, Trivedi DJ, Sagare AA. Serum HS-CRP and Uric acid as indicator of severity in preeclampsia. Int J Pharm Bio Sci 2011; 2: 340-345.
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13. Powers RW, Ness RB, Cooper KM, Gallaher MJ, Frank MP, Daftary AR, Roberts JM. Uric acid concentrations in early pregnancy among preeclamptic women with gestational hyperuricemia at delivery. AJOG 2006; 194: . [DOI:10.1016/j.ajog.2005.06.066]
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15. Chen Q LS, Tong M, Wei J, Shen F, Zhao J, Zhao M. Serum uric acid may not be involved in the development of preeclampsia. J Hum Hypertens 2016; 30: 136-140. [DOI:10.1038/jhh.2015.47]
16. Laughon SK, Catov J, Powers RW, Roberts JM, Gandley RE. First trimester uric acid and adverse pregnancy outcomes. Am J Hypertens 2011; 24: 489-495. [DOI:10.1038/ajh.2010.262]
17. Hawkins TL, Roberts JM, Mangos GJ, Davis GK, Roberts LM, Brown MA. Plasma uric acid remains a marker of poor outcome in hypertensive pregnancy: a retrospective cohort study. BJOG 2012; 119: 484-492. [DOI:10.1111/j.1471-0528.2011.03232.x]
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19. Masoura S, Makedou K, Theodoridis T, Kourtis A, Zepiridis L, Athanasiadis A. The involvement of uric acid in the pathogenesis of preeclampsia. Curr Hypertens Rev 2015; 11: 110-115. [DOI:10.2174/1573402111666150529130703]
20. Corominas AI, Balconi SM, Palermo M, Maskin B, Damiano AE. Serum uric acid levels and risk of developing preeclampsia. Medicina 2014; 74: 462-471.
21. Zhao J ZD, Yang JM, Wang M, Zhang XT, Sun L, Yun XG. Maternal serum uric acid concentration is associated with the expression of tumour necrosis factor-alpha and intercellular adhesion molecule-1 in patients with preeclampsia. J Hum Hypertens 2016; 30: 456-462. [DOI:10.1038/jhh.2015.110]
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23. Thangaratinam S, Ismail KM, Sharp S, Coomarasamy A, Khan KS, Tests in Prediction of Pre-eclampsia Severity review g. Accuracy of serum uric acid in predicting complications of pre-eclampsia: a systematic review. BJOG 2006; 113: 369-378. [DOI:10.1111/j.1471-0528.2006.00908.x]
24. Koopmans CM vPM, Groen H, Aarnoudse JG, van den Berg PP, Mol BW. Accuracy of serum uric acid as a predictive test for maternal complications in pre-eclampsia: bivariate meta-analysis and decision analysis. Eur J Obstet Gynecol Reprod Biol 2009; 146: 8-14. [DOI:10.1016/j.ejogrb.2009.05.014]
25. Roberts JM BL, Lain KY, Hubel CA, Markovic N, Ness RB, Powers RW. Uric acid is as important as proteinuria in identifying fetal risk in women with gestational hypertension. Hypertension 2005; 46: 1263-1269. [DOI:10.1161/01.HYP.0000188703.27002.14]
26. Andrews L ML, Sharma A, Haridas N, Vaishnav S, Jadav P. Maternal outcome in relation to Biochemical parameters in Hypertensive disorders in Pregnancy. IOSR J Dental Med Sci 2014; 13: 18-22.
27. Patel Tejal DA. R elationship of Serum Uric Acid Level to Maternal and Perinatal Outcome in Patients with Hypertensive Disorders of Pregnancy. GUJARAT MED J 2014; 69: 45-47.
28. Wu Y, Xiong X, Fraser WD, Luo ZC. Association of uric acid with progression to preeclampsia and development of adverse conditions in gestational hypertensive pregnancies. Am J Hypertens 2012; 25:711-717. [DOI:10.1038/ajh.2012.18]
29. Scifres CM, Macones GA. The utility of thrombophilia testing in pregnant women with thrombosis: fact or fiction? AJOG 2008; 199: 344. [DOI:10.1016/j.ajog.2008.04.051]
30. Gary cunningham Jk, al Le. Williams Obstetrics. United States of America, Mc Graw-Hill Companies; 2014: 746-750.
31. Livingston JR PB, Brown M, Roberts JM, Côté AM, Magee LA, von Dadelszen P. Uric Acid as a predictor of adverse maternal and perinatal outcomes in women hospitalized with preeclampsia. J Obstet Gynaecol Can 2014; 36: 870-877. [DOI:10.1016/S1701-2163(15)30435-7]
32. Savaj S, Vaziri N. An overview of recent advances in pathogenesis and diagnosis of preeclampsia. Iran J Kidney Dis 2012; 6: 334-338.
33. Alavi AJK, Karimia S, Arabzadea N, S F. Comparison of serum calcium, total protein and uric acid levels between hypertensive and healthy pregnant women in an Iranian population. Life Sci J 2012; 9: 485-488.
34. Macdonald-Wallis C, Lawlor DA, Fraser A, May M, Nelson SM, Tilling K. Blood pressure change in normotensive, gestational hypertensive, preeclamptic, and essential hypertensive pregnancies. Hypertension 2012; 59: 1241-1248. [DOI:10.1161/HYPERTENSIONAHA.111.187039]
35. Suchanda Sahu MD, Rebecca Abraham R. Vedavalli V. Senthilvel. Study of uric acid and nitric oxide concentrations in preeclampsia and normal pregnancy. Int J Biol Med Res 2011; 2: 390-393.
36. Bellomo G, Venanzi S, Saronio P, Verdura C, Narducci PL. Prognostic significance of serum uric acid in women with gestational hypertension. Hypertension 2011; 58: 704-708. [DOI:10.1161/HYPERTENSIONAHA.111.177212]
37. Bargale A, GAnu JV, Trivedi DJ, Sagare AA. Serum HS-CRP and Uric acid as indicator of severity in preeclampsia. Int J Pharm Bio Sci 2011; 2: 340-345.
38. Martin AC BM. Could uric acid have a pathogenic role in pre-eclampsia? Nat Rev Nephrol 2010; 6: 744-748. [DOI:10.1038/nrneph.2010.125]
39. Enaruna NO, Idemudia JO, Aikoriogie PI. Serum lipid profile and uric acid levels in preeclampsia in University of Benin Teaching Hospital. Niger Med J 2014; 55: 423-427. [DOI:10.4103/0300-1652.140387]
40. Feig DI, Kang DH, Johnson RJ. Uric acid and cardiovascular risk. N Engl J Med 2008; 23: 1811-1821. [DOI:10.1056/NEJMra0800885]
41. Powers RW, Ness RB, Cooper KM, Gallaher MJ, Frank MP, Daftary AR, Roberts JM. Uric acid concentrations in early pregnancy among preeclamptic women with gestational hyperuricemia at delivery. AJOG 2006; 194: . [DOI:10.1016/j.ajog.2005.06.066]
42. Sultana R AS, Sultana N, Karim S.M. F, Atia F. Association of Serum Uric Acid with Preeclampsia: A Case Control Study. Delta Med Col J 2013; 1: 46-50. [DOI:10.3329/dmcj.v1i2.15918]
43. Chen Q LS, Tong M, Wei J, Shen F, Zhao J, Zhao M. Serum uric acid may not be involved in the development of preeclampsia. J Hum Hypertens 2016; 30: 136-140. [DOI:10.1038/jhh.2015.47]
44. Laughon SK, Catov J, Powers RW, Roberts JM, Gandley RE. First trimester uric acid and adverse pregnancy outcomes. Am J Hypertens 2011; 24: 489-495. [DOI:10.1038/ajh.2010.262]
45. Hawkins TL, Roberts JM, Mangos GJ, Davis GK, Roberts LM, Brown MA. Plasma uric acid remains a marker of poor outcome in hypertensive pregnancy: a retrospective cohort study. BJOG 2012; 119: 484-492. [DOI:10.1111/j.1471-0528.2011.03232.x]
46. Elmas O AY, Simsek T. The relationship between hypertension and plasma allantoin, uric acid, xanthine oxidase activity and nitrite, and their predictive capacity in severe preeclampsia. J Obstet Gynaecol 2016; 36: 34-38. [DOI:10.3109/01443615.2015.1030608]
47. Masoura S, Makedou K, Theodoridis T, Kourtis A, Zepiridis L, Athanasiadis A. The involvement of uric acid in the pathogenesis of preeclampsia. Curr Hypertens Rev 2015; 11: 110-115. [DOI:10.2174/1573402111666150529130703]
48. Corominas AI, Balconi SM, Palermo M, Maskin B, Damiano AE. Serum uric acid levels and risk of developing preeclampsia. Medicina 2014; 74: 462-471.
49. Zhao J ZD, Yang JM, Wang M, Zhang XT, Sun L, Yun XG. Maternal serum uric acid concentration is associated with the expression of tumour necrosis factor-alpha and intercellular adhesion molecule-1 in patients with preeclampsia. J Hum Hypertens 2016; 30: 456-462. [DOI:10.1038/jhh.2015.110]
50. Matias ML, Romao M, Weel IC, Ribeiro VR, Nunes PR, Borges VT, et al. Endogenous and Uric Acid-Induced Activation of NLRP3 Inflammasome in Pregnant Women with Preeclampsia. PloS One 2015; 10: e0129095. [DOI:10.1371/journal.pone.0129095]
51. Thangaratinam S, Ismail KM, Sharp S, Coomarasamy A, Khan KS, Tests in Prediction of Pre-eclampsia Severity review g. Accuracy of serum uric acid in predicting complications of pre-eclampsia: a systematic review. BJOG 2006; 113: 369-378. [DOI:10.1111/j.1471-0528.2006.00908.x]
52. Koopmans CM vPM, Groen H, Aarnoudse JG, van den Berg PP, Mol BW. Accuracy of serum uric acid as a predictive test for maternal complications in pre-eclampsia: bivariate meta-analysis and decision analysis. Eur J Obstet Gynecol Reprod Biol 2009; 146: 8-14. [DOI:10.1016/j.ejogrb.2009.05.014]
53. Roberts JM BL, Lain KY, Hubel CA, Markovic N, Ness RB, Powers RW. Uric acid is as important as proteinuria in identifying fetal risk in women with gestational hypertension. Hypertension 2005; 46: 1263-1269. [DOI:10.1161/01.HYP.0000188703.27002.14]
54. Andrews L ML, Sharma A, Haridas N, Vaishnav S, Jadav P. Maternal outcome in relation to Biochemical parameters in Hypertensive disorders in Pregnancy. IOSR J Dental Med Sci 2014; 13: 18-22.
55. Patel Tejal DA. R elationship of Serum Uric Acid Level to Maternal and Perinatal Outcome in Patients with Hypertensive Disorders of Pregnancy. GUJARAT MED J 2014; 69: 45-47.
56. Wu Y, Xiong X, Fraser WD, Luo ZC. Association of uric acid with progression to preeclampsia and development of adverse conditions in gestational hypertensive pregnancies. Am J Hypertens 2012; 25:711-717. [DOI:10.1038/ajh.2012.18]
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