The Correlation of Maternal Uric Acid Concentration with Small-for-Gestational-Age Fetuses in Normotensive Pregnant Women

Abstract

Aim: Elevated maternal serum uric acid is associated with small-for-gestational-age (SGA) fetuses. We investigated whether uric acid concentrations in normotensive pregnant women are correlated with fetal growth and related to kidney function. Methods: We carried out a case-control study using 40 patients who delivered SGA fetuses identified from the perinatal database and 80 patients who delivered appropriate-for-gestational-age (AGA) fetuses as the controls at Okayama University Hospital. Blood pressure, serum uric acid and creatinine level were measured in the patients’ third trimester. Results:Maternal serum uric acid (p = 0.0003) and creatinine (p < 0.0001) concentrations, as well as systolic and diastolic blood pressures (p =0.014 and 0.037, respectively), were significantly increased in the SGA group. There was a strong negative correlation between serum uric acid levels and birth weights (r = –0.59; p = 0.006) and a significant positive correlation between maternal serum uric acid and creatinine levels (r = 0.43; p < 0.05) in cases of severe SGA (<5th percentile). Multiple linear regression analysis indicated that uric acid is an independent risk factor for SGA.Conclusions: Increasing maternal uric acid concentrations were associated with slightly impaired kidney function and SGA in normotensive pregnant women.

Maternal hyperuricemia in normotensive singleton pregnancy, a prenatal finding with continuous perinatal and postnatal effects, a prospective cohort study

“…These findings are consistent with other studies conducted in different populations and durations of pregnancy; Laughon et al studied 212 normotensive pregnant women in Pittsburgh and reported that hyperuricemia during the second trimester or pregnancy was associated with a lower birth weight [23]. In another study of 120 Japanese normotensive pregnant women, Akahori et al documented that hyperuricemia in the third trimester of pregnancy is an independent risk factor for SGA delivery [4]. These results fulfill two important criteria in evaluating the causal relationship of associated factors: 1) consistency of the associations among studies conducted in different circumstances; and 2) the exposure occurred before the outcome.…”

“…These associations have also been identified by other studies [4,14]. The association of excessive weight gain and impaired renal function with hyperuricemia can be explained by the overproduction and reduced renal excretion of uric acid, respectively [14].…”

“…Elevated plasma uric acid is an independent risk factor for preterm birth, low birth weight (LBW) delivery and low 1- and 5-minute Apgar scores [4-6]. These findings have led some researchers to recommend screening for hyperuricemia during pregnancy as a useful way to lower adverse pregnancy outcomes [7].…”

Maternal Glomerular Filtration Rate in Pregnancy and Fetal Size

“…Indirect measures of GFR in pregnancy, such as serum creatinine and uric acid, also support a positive relationship with birth weight [11]–[13]. Of the existing studies relevant to the GFR-fetal size relationship, none have quantitated it in straightforward physiologic terms such as grams per fetal weight per ml/min GFR.…”

The value of serum uric acid in predicting adverse pregnancy outcomes of women with hypertensive disorders of pregnancy

“…In a cohort study involving 1,487 cases, Joel R. [17] also confirmed Hawkins' conclusion, wherein he considered that the corrected UA according to gestational age can better predict adverse perinatal outcomes than random UA value, and its sensitivity and specificity were 93% and 27%, respectively. Through comparing the perinatal period information of women who have normal blood pressure, but respectively deliver small-for-gestational age infants and infants of right age, Akahori Y. et al [18] found that the levels of hematuria acid, creatinine and blood pressure of the former were obviously higher than those of the latter. Increased SUA is correlated to mild kidney function damage and LBW infants.…”