Uric Acid in Pregnancy: New Concepts

The relationship between hyperuricemia and hypertensive disorders is well established; however, until today, the role of uric acid in the clinical course of severe preeclampsia has not been elucidated. Some recent studies suggest that at the time of presentation, subjects with severe preeclampsia frequently have significantly elevated serum uric acid levels, and that the degree of elevation correlates with the severity of the maternal syndrome and fetal morbimortality. In this chapter, we present our workgroup experience. In 2016, we designed a prospective, cross-sectional comparative study. A sample of 200 patients - 100 with severe preeclampsia and 100 with normotensive pregnancy - was obtained. Plasmatic uric acid levels were recorded in units of mg/dL as clinical variables and as laboratory and fetal growth data. We considered uric acid equal to or more than 6.0 mg/dL as the elevated level. To relate the significance of elevated uric acid levels with variables, chi-square tests and Mann-Whitney U test were applied. Any p value equal or <0.05 was accepted as significant. We found significant difference (p = 0.05) between serum uric acid levels among both groups. In comparison with the healthy patients, patients with severe preeclampsia and uric acid greater than 6 mg/dl presented significant differences in relation to fetal complications and maternal laboratory and clinical variables. Our conclusion is that values equal to or greater than 6 mg/dL of serum uric acid in patients with severe preeclampsia may be a valuable biomarker for preeclampsia and an association with the presence of adverse fetal and maternal effects.