Association of maternal uric acid and cystatin C serum concentrations with maternal and neonatal cardiovascular risk markers and neonatal body composition: The Ulm SPATZ Health Study

Abstract

PurposeIn utero exposure to cardiometabolic risk factors may determine health related outcomes at birth and in later life. The aim of this analysis was to describe the relationship of maternal serum uric acid (SUA) and cystatin C with maternal and neonatal cardiometabolic risk markers and with birth weight and risk of small-for-gestational age (SGA) as well as large-for gestational age (LGA).Material and methodsIn the Ulm SPATZ Health Study, 934 singleton newborns and their mothers were recruited during their hospital stay in the University Medical Center Ulm between 04/2012 and 05/2013 (overall response 49%). The association between SUA and cystatin C (both in quartiles and as continuous measures) with risk for SGA as well as with LGA was quantified by means of multivariable logistic regression.ResultsOverall, n = 885 mother-newborn pairs were included in the final analysis. Most of the mothers were of German nationality (85%) and were between 26 and 35 years of age at delivery (69%). Maternal SUA was associated with maternal age, body mass index, alcohol consumption and history of hypertension as well as with many other maternal and neonate cardiovascular risk markers. Cystatin C was associated with parity. No clear association of SUA with SGA and LGA was observed in fully adjusted models. However, cystatin C was negatively associated with SGA with an odds ratio (OR) of 0.35 (95% CI: 0.16–0.77; p for trend 0.04) comparing the top quartile vs. the bottom quartile and was positively associated with LGA with an OR of 5.92 (95% CI: 2.27–15.44; p for trend <0.0001) after adjustment for covariates.ConclusionsWe found a positive association of cystatin C with birth weight and a clearly increased risk for LGA with maternal increased cystatin C values in a population with fairly normal renal function.

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

“… 8 By contrast, in a recent study of 885 pregnant women from Germany, Rothenbacher et al indicated that maternal increased CysC levels (Q4) were associated with an increased risk for LGA and a decreased risk for SGA compared to Q1 (for LGA, OR = 5.92, 95% CI: 2.27, 15.44; for SGA, OR = 0.35, 95% CI: 0.16, 0.77), and there was no association between UA and birth weight. 10 In our cohort study, the associations between high CysC levels and an increased risk of LGA and between high UA levels and an elevated risk of SGA were extended to the Chinese population. Previous reports suggested that women with GDM had a higher incidence of LGA compared to those without pregnancy complications among individuals who underwent serum screening for Down syndrome (25.82% vs 13.80%) or noninvasive prenatal screening (29.7% vs 18.6%).…”

“…7–9 In a recent study of 885 mothers and their singleton newborns, Rothenbacher et al showed an inverse correlation of maternal high UA with a reduced risk of SGA in an age-adjusted analysis. 10 …”

“… 11–16 However, little is known about CysC levels and other adverse pregnancy outcomes, such as gestational diabetes mellitus (GDM), intrahepatic cholestasis of pregnancy (ICP), PTB, SGA, large for gestational age (LGA) infants, LBW, and macrosomia. 10 A few reports on the relationship between the CysC concentration and PTB are also inconsistent. 8 , 17 , 18 …”

Renal Function Tests in Women with Preeclampsia with and without Intrauterine Growth Restriction

“…However, cystatin C was found to be negatively associated with SGA with an odds ratio [OR ] of 0.35 [95% CI: 0.16±0.77 ]. [28] Another case-control study was performed by SK Srinivas, AG Edlow, PM Neff, MD Samme, CM Andrela1 and MA Elovitz et al . Cases were patients with preeclampsia.…”

Assessment Of Predictive Value Of Serum Uric Acid Levels For Low Birth Weight In Pre-Eclampsia

“…Different tests and parameters, including uric acid are being carried out in 2nd or 3rd trimester of pregnancy as a predictor of preeclampsia. 4 One study found that frequency of low birth weight was 36.2% in women having hyperuricemia & hypertension during pregnancy. 5 Study carried by Ryu et al mean uric acid level was 5.8 ranging from (4.7 -6.6) in pre-eclamptic women compared to 3.9 and ranging from (3.1 -4.6) in patients with normal blood pressure.…”