Gout in pregnancy: Obstetric and neonatal outcomes

The pregnancy, delivery, and neonatal outcomes of pregnancies complicated by gout have yet to be evaluated in a population-based study. We sought to evaluate the obstetric and neonatal outcomes in pregnant patients with gout using a national population database.

This is a retrospective population-based cohort study utilizing the Healthcare Cost and Utilization Project, Nationwide Inpatient Sample (HCUP-NIS). All women who delivered or had a maternal death in the USA (2004-2014) were included in the study. Pregnancy, delivery, and neonatal outcomes were compared between women with an ICD-9 diagnosis of gout to those without.

Overall, 9 096 788 women met the inclusion criteria. Of these, 168 women (1.8/100000) had gout. Patients with gout, compared to those without, were more likely to be older and obese and to have chronic hypertension, pregestational diabetes mellitus, and thyroid disease. Pregnant women with gout were more likely to develop gestational diabetes mellitus (aOR 1.78 [95% CI 1.17-2.72], P = 0.008), to require operative vaginal delivery (aOR 3.26 [95% CI 2.03-5.22], P = 0.0001), and to experience venous thromboembolism (aOR 8.47 [95% CI 2.06-34.82], P = 0.003) compared to pregnant patients without gout. Patients with gout were more likely to deliver a neonate with congenital anomalies compared to those without gout (aOR 3.38 [95% CI 1.24-9.20], P = 0.02).

Gout in pregnancy, or pregnancies complicated by a history of gout, are associated with increased risk of gestational diabetes mellitus, pulmonary embolism, and neonatal anomalies.