Relationship of serum uric acid, serum creatinine and serum cystatin C with maternal and fetal outcomes in rural Indian pregnant women

Abstract

BackgroundHypertensive disorders are the most common in pregnancy. Several studies showed a positive correlation between elevated maternal serum uric acid (UA), serum creatinine and adverse maternal and fetal outcomes, but only a few studies are available on serum cystatin C and maternal and fetal outcomes. The present study was undertaken to study the association of serum UA, creatinine and cystatin C with maternal and fetal outcomes.MethodsOut of 116 pregnant women 69 women had no hypertension and 47 had hypertension with or without proteinuria. Serum UA, creatinine and cystatin C was measured by modified Uricase method, modified kinetic Jaffe’s reaction and particle-enhanced immunonephelometric assay respectively. Multivariate logistic regression was performed to determine the independent effects of serum UA, creatinine and cystatin C on maternal and fetal outcomes using stata 13.1.ResultsThe adjusted odds ratio (OR) was 3.73 (95% CI: 1.18-11.75; P=0.024) for UA; 15.79 (95% CI: 3.04-81.94; P=0.001) for creatinine and 2.03 (95% CI: 0.70-5.87; P=0.192) for cystatin C in hypertensive disorders of pregnancy. All the three renal parameters were not significantly associated with birth weight, gestational age of delivery and mode of delivery after adjusting for the confounding factors.ConclusionsSerum creatinine and uric acid are independent risk factors for hypertensive disorders of pregnancy. High serum uric acid is associated with low birth weight and delivery by caesarian section whereas high serum creatinine with preterm delivery only before adjustment for confounding factors and not after adjustment. Serum cystatin C was not significantly associated with the maternal and fetal outcomes.

Uric acid as an important biomarker in hypertensive disorders in pregnancy

“…Krishna S et al, Thanna et al, Yalamati P et al, concluded that high serum uric acid level could be a useful indicator of the maternal and fetal complication which is comparable to our study. [20][21][22] Hawkins TL et al, studied of hypertensive pregnant women (those with pre-eclampsia or gestational hypertension) the risk of adverse maternal outcome and adverse fetal outcome increased with increasing concentration of uric acid which is compared to our study. 23 …”

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

“…In contrast, in a study from India including 116 pregnant women, high SUA were associated with low birthweight < 2.5 kg in crude analyses, but no longer after multivariable adjustment. Both markers analyzed in their study (SUA and creatinine), however, were associated with maternal hypertensive disorders in pregnancy [ 12 ].…”

“…Renal function, as assessed by cystatin C levels, a reliable marker for renal function, in pregnancy may also be indicators of maternal cardiometabolic disease [ 7 ] affecting fetal health. Several studies described the relationship between maternal SUA, renal function and fetal outcomes [ 8 – 12 ] and results are controversial.…”

Serum uric acid and high-risk pregnancy: an intriguing correlation in advanced pregnant women

“…Increased serum UA levels have been reported to be associated with hypertension, diabetes mellitus and metabolic syndrome (14-16). On the other hand, elevated serum UA concentrations have been observed in patients with pregnancy-related diseases, such as gestational hypertension, eclampsia and gestational diabetes mellitus (8,9,17). In our study, we found that serum UA was correlated with HRP score in advanced pregnant women.…”

“…Recently, serum UA has been reported to be associated with various diseases such as cardiovascular disease, hypertension and metabolic syndrome (6). Previous study attested that serum UA was related with adverse pregnancy outcomes in pregnant woman with chronic glomerulonephritis (7), and serum UA concentrations have been found to be increased in patients with gestational hypertension and preeclampsia (8,9). Obviously, serum UA maintains a close association with pregnancy-related diseases.…”