Predictive value of early pregnancy uric acid levels for adverse pregnancy outcomes

Elevated serum uric acid (SUA) levels in pregnancy are linked to adverse outcomes, including preterm birth, preeclampsia, and low birth weight. To assess the predictive value of SUA levels in early pregnancy for adverse pregnancy outcomes (APOs). A cohort of 4,240 pregnant women admitted for delivery from January 2021 to December 2022 was analyzed. APOs were compared between women with hyperuricemia (HUA) (UA > 360 μmol/L) and those without HUA. Logistic regression (LR) analysis was used to identify risk factors for APOs. Among the cohort, 295 women (6.9%) had HUA. Compared to the non-HUA group, the HUA group had a higher BMI (22.45 vs. 21.34), higher rates of hypertension (6.1% vs. 3.4%), preterm birth (10.2% vs. 6.3%), and low birth weight (10.2% vs. 5.9%). Multivariate LR analysis identified elevated UA levels, BMI, diabetes, and preeclampsia as significant risk factors for APOs. The optimal UA threshold for predicting preterm birth was 253.855 μmol/L (sensitivity: 71.4%, specificity: 55.2%). Early pregnancy SUA levels are predictive of adverse pregnancy outcomes, providing a foundation for potential clinical interventions. Given the moderate sensitivity and specificity of the identified SUA threshold for predicting preterm birth, further research is warranted to refine these values and establish their clinical implications in obstetric practice.