Association of Maternal Serum Uric Acid and Cystatin C Levels in Late Pregnancy with Adverse Birth Outcomes: An Observational Cohort Study in China

Abstract

Objective To investigate the associations between serum uric acid (UA) and cystatin C (CysC) levels in late pregnancy with major unfavorable birth outcomes. Methods We retrospectively analyzed the maternal UA and CysC levels during late pregnancy and their relationship with unfavorable birth outcomes in a Chinese population (n = 11,580). Results Women with the highest quartile of UA had higher risks of low birth weight (LBW) and small for gestational age (SGA) babies and a lower risk of preterm birth (PTB) compared to women with the lowest quartile [for LBW, adjusted-odds ratio (OR) = 2.63, 95% CI: 1.76, 3.95; for SGA, adjusted-OR = 2.11, 95% CI: 1.73, 2.57; for PTB, adjusted-OR = 0.55, 95% CI: 0.45, 0.69; all P for trend <0.001]. Compared to women in the lowest quartile of CysC, higher risks of macrosomia and large for gestational age (LGA) and lower risks of PTB and SGA were observed for those in the highest quartile (for macrosomia, adjusted-OR = 2.01, 95% CI: 1.60, 2.51; for LGA, adjusted-OR = 1.97, 95% CI: 1.67, 2.32; for PTB, adjusted-OR = 0.32, 95% CI: 0.26, 0.41; all P for trend <0.001; for SGA, adjusted-OR = 0.78, 95% CI: 0.64, 0.96; P for trend <0.05). Conclusion This study reports the associations of maternal UA and CysC with adverse birth outcomes, and suggests that routine determination of maternal UA and CysC in late pregnancy is beneficial for assessing the risks of these outcomes.

Maternal uric acid levels and risk of gestational diabetes mellitus: A systematic review and dose–response meta‐analysis of cohort studies including 105,380 participants

“…Furthermore, 19 studies were excluded after the full-text screening. Finally, 23 studies were eligible for inclusion in the present study [18][19][20][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] . Table 1 summarizes the characteristics of the included studies.…”

“…The maternal blood uric acid concentration during pregnancy was measured in 21 of 23 studies at or before the 20th week of gestation [18][19][20]25,[27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] , and the remaining studies measured it after the 20th week of gestation 26,44 . The maternal blood uric acid concentration during pregnancy was measured using calorimetric assays 18,20,25,27,28,[30][31][32][33][36][37][38][39]41 or a spectrometric method 29 , whereas eight out of 23 included studies did not provide data regarding the method of maternal blood uric acid measurement 19,26,34,35,40,[42][43][44] . Among the 23 included studies, five studies collected blood samples after 8-12 h of fasting for the measurement of maternal uric acid…”

“…The maternal blood uric acid concentration during pregnancy was measured using calorimetric assays 18,20,25,27,28,[30][31][32][33][36][37][38][39]41 or a spectrometric method 29 , whereas eight out of 23 included studies did not provide data regarding the method of maternal blood uric acid measurement 19,26,34,35,40,[42][43][44] . Among the 23 included studies, five studies collected blood samples after 8-12 h of fasting for the measurement of maternal uric acid 19,27,33,34,39 ; the remaining studies did not report the method by which blood samples were collected 18,20,25,26,[28][29][30][31][32][35][36][37][38][40][41][42][43][44] . Among the studies included in this systematic review, 13 studies were carried out on participants who were primiparous or multiparous…”

“…Among the 23 included studies, five studies collected blood samples after 8-12 h of fasting for the measurement of maternal uric acid 19,27,33,34,39 ; the remaining studies did not report the method by which blood samples were collected 18,20,25,26,[28][29][30][31][32][35][36][37][38][40][41][42][43][44] . Among the studies included in this systematic review, 13 studies were carried out on participants who were primiparous or multiparous 18,25,[29][30][31]33,[35][36][37][38][39][40]43 , seven studies were carried out on participants who were primiparous 19,20,26,27,32,41,44 and four studies did not mention the participants' parity status 28,34,42 . Furthermore, out of all eligible studies, no studies have been carried out on pregnant women who were multiple pregnancies (two or more babies ...…”

“…All studies had a longitudinal design, which were cohort 18,20,[27][28][29][30][31][32][33][34][35][36][37][38][39][41][42][43] and retrospective cohort designs 19,25,26,40,44 . The quality assessment of the included studies using the Newcastle-Ottawa scale is provided in Table 2.…”