The prognostic role of serum uric acid levels in preeclampsia: A meta‐analysis

Abstract

This meta-analysis aims to compare serum uric acid levels among preeclamptic and healthy pregnant women across the various trimesters and provide a summary of the effect size of this biomarker in predicting adverse pregnancy outcomes. MEDLINE, Scopus, CENTRAL, Clinicaltrials.gov, and Google Scholar databases were systematically searched from inception. Observational studies were held eligible if they reported serum uric acid among preeclamptic and healthy pregnant women. Metaanalysis was conducted regarding uric acid concentration, diagnostic accuracy, and association with perinatal outcomes. The credibility of evidence was appraised using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. The analysis included 196 studies, comprising 39 540 women.Preeclampsia was associated with significantly elevated uric acid levels during the 1st (mean difference [MD]: 0.21 mg/dL, 95% confidence intervals [CI]: 0.06-0.35) trimester, 2nd (MD: 1.41 mg/dL, 95% CI: 0.78-2.05) trimester, and 3rd (MD: 2.26 mg/dL, 95% CI: 2.12-2.40) trimester. Higher uric acid was estimated for severe preeclampsia, eclampsia, and hemolysis, elevated liver enzymes, low platelet syndrome. The sensitivity for adverse perinatal outcome prediction ranged from 67.3% to 82.7% and the specificity from 47.7% to 70.7%. In conclusion, it is suggested that serum uric acid levels are increased in preeclampsia and can be used to predict disease severity and pregnancy complications. Future prospective studies should verify these outcomes, assess the optimal cutoffs, and incorporate uric acid to combined predicting models. S U PP O RTI N G I N FO R M ATI O NAdditional supporting information may be found online in the Supporting Information section. How to cite this article: Bellos I, Pergialiotis V, Loutradis D, Daskalakis G. The prognostic role of serum uric acid levels in preeclampsia: A meta-analysis. J Clin Hypertens. 2020;22: 826-834. https://doi.

Serum LDH values in hypertensive disorders of pregnancy and their association with maternal and neonatal morbidity: a meta-analysis

“…Data extraction was performed using a modified data form that was based in Cochrane's data collection form for intervention reviews for RCTs and non-RCTs [15]. Investigated outcomes were predetermined based in our previous systematic review that examined the role of serum uric acid as a predictive factor of preeclampsia [16]. Briefly, the main outcome of interest was the comparison of serum LDH levels among preeclamptic and healthy pregnant women in all gestational trimesters.…”

Uric acid participating in female reproductive disorders: a review

“…Our understanding of the role of UA in the reproductive system is also growing as more literature is added. Serum UA levels have been proposed to predict the occurrence of PE and adverse maternal and foetal outcomes [5]. A model containing UA and hypoxanthine has also been constructed to diagnose the prognosis of minimal/mild endometriosis with a sensitivity of 66.7 % and specificity of 90.0 % [103].…”

“…Elevated serum UA levels are considered to be a predictor of maternal and infant complications, so early measurement of serum UA may be beneficial in the diagnostic treatment of this clinical syndrome. The sensitivity from the study by Bellos et al [ 5 ] for predicting adverse perinatal outcomes in patients with PE with high UA levels ranged from 67.3 to 82.7 %, and the specificity ranged from 47.7 to 70.7 %. In women with PE/eclampsia, high UA levels are considered in most studies to be a good predictor of foetal/neonatal complications.…”

“…Some literature has reported that UA levels tend to be elevated to higher levels in some patients, such as those with polycystic ovary syndrome (PCOS), and correlate with clinical severity [4]. Additionally, trials targeting drugs to control UA levels have provided positive results, and some scholars have used UA levels to predict the occurrence of pregnancy complications and adverse maternal and infant risks [5][6][7][8]. These findings led us to question whether there is a close relationship between UA and female reproductive disorders.…”

Neck Circumference Is a Reliable Predictor for Hyperuricemia in Women With Polycystic Ovary Syndrome: a Case Control Study

“…Previously, our study demonstrated that the prevalence of hyperuricemia in the PCOS population was almost threefold higher than that in women without PCOS(8). Moreover, serum uric acid can be used as a predictor of adverse pregnancy and foetal outcomes (9,10). Therefore, the early detection and intervention of hyperuricemia is of great signi cance for the health of women with PCOS.…”