Correlation between serum uric acid levels and outcomes of pre-eclampsia in Abakaliki, South-east, Nigeria
DOI:
https://doi.org/10.18203/2320-6012.ijrms20213913Keywords:
Correlation, Serum uric acid, Pre-eclampsia, OutcomesAbstract
Background: Pre-eclampsia is a leading cause of fetomaternal and perinatal morbidity and mortality. The role of serum uric acid (SUA) in determining the complications of preeclampsia has been controversial. This study compared mean SUA levels between severe pre-eclamptics and normotensive women at term and ascertained its correlation with outcomes of preeclampsia; as well as determined if there is a threshold value of SUA level beyond which fetomaternal complications occur.
Methods: A case-controlled study where 80 severe pre-eclamptics at term and 80 normotensive women matched for gestational age were recruited. Blood samples were collected from them for assay of SUA levels and they were followed till delivery. The fetomaternal outcomes and the corresponding SUA levels at diagnosis were documented and variables statistically analyzed. A receiver operating characteristic curve was used to determine the cut-off value of SUA beyond which adverse fetomateral complications are likely to occur in pre-eclampsia.
Results: The mean SUA level in severe pre-eclamptics (0.283±0.09 mmol/l) was not significantly higher than that of normotensive women (0.263±0.09 mmol/l, p=0.13). There was a weak positive correlation between the SUA levels and fetomaternal outcomes [maternal (r=0.102, p=0.236) and fetal (r=0.096, p=0.226)]. The study was unable to identify the threshold SUA level at which adverse fetomaternal outcomes occur as the values of SUA were closely related.
Conclusions: SUA levels of pre-eclamptics and normotensive women did not show significant difference and correlated weakly with fetomaternal outcomes and are therefore poor predictor of fetomaternal outcomes in pre-eclampsia.
References
Wagner LK. Diagnosis and management of preeclampsia. Am Fam Physician. 2004;70(12):2317-24.
Park JH, Chung D, Cho HY, Kim YH, Son GY, Park YW, Kwon JY. Random Urine Protein/Creatinine Ratio Readily Predicts Proteinuria in Preeclampsia. Obstet Gynecol Sci. 2013;56(1):8-14.
Uzan J, Carbonnel M, Piconne O, Asmar R. Ayoubi JM. Pre-eclampsia: Pathophysiology, Diagnosis, and Management. Vascular Health Risk Management. 2011;7:467-74.
Toshinwal S, Lamba AR. Serum uric acid as a marker of severity of preeclampsia. Int J Reprod Contracept Obstet Gynecol. 2017;6(11):4915-7.
Rajalaxmi KK, Nayak SR, Shantharam M. Serum uric acid level in Pre-eclampsia and its correlation to maternal and fetal outcome. IJBR. 2020;9(11):4344-9.
World Health Organization. Trends in Maternal Mortality: 1990 to 2008. 2010. Available at: www.who.int/monitoring. Accessed on 27 November 2019.
Singh S, Ekele BA, Shehu CE, Nwobodo EI. Hypertensive disorders in pregnancy among pregnant women in a Nigerian Teaching Hospital. Nig Med J. 2014;55(5):384-8.
Tranquilli AL, Brown MA. Zeeman GG, Dekker G, Sibai BM. The definition of severe and early-onset preeclampsia. Statements from the International Society for the Study of Hypertension in Pregnancy (ISSHP). Int J Women Cardiovascular Health. 2013;3:44-7.
Abubakar A, Abdullahi RA, Jibril HZ, Dauda MN, Poopola MA. Maternal Ethnicity and Severity of Pre-eclampsia in Northern Nigeria. Asian J Med Sci. 2009;1(3):104-7.
Kooffreh ME, Ekott M, Ekpoudom DO. The prevalence of pre-eclampsia among pregnant women in the University of Calabar Teaching Hospital, Calabar. Saudi J Health Sci. 2014;3:133-6.
Ekine AA, Jeremiah I, Harry TC, West OL. Factors influencing the prevalence of Preeclampsia-eclampsia in booked and unbooked patients: 3 years retrospective study in NDUTH, Okolobiri. World J Med Med Sci. 2015;3(1):1-14.
Agwu UM, Ifebunandu N, Obuna AJ, Nworie EO, Nwopoko SO, Umeora OUJ. Prevalence of Medical Disorders in Pregnancy in Ebonyi State University Teaching Hospital. J Basic Clin Reprod Sci. 2013;2(1):22-6.
Ajah L, Ozonu NC, Ezeonu PO, Lawani LO, Obuna JA, Onwe EO. The fetomaternal outcome of preelampsia with severe features and eclampsia in Abakaliki, South-East Nigeria. J Clin Diagnost Res. 2016;10(9):18-30.
Jido TA, Yakasai IA. Pre-eclampsia: A review of evidence. Ann Afr Med. 2013;12(2):75-85.
Chen Q, Lau S, Tong M, Wei J, Shen F, Zhao J, Zhao M. Serum uric acid may not be involved in the development of preeclampsia. J Human Hyperten. 2016;30(2):136-40.
Sabitha k, Gopal BV, Raj KG, Rafi MD, Sudhakar T, Ramadevi C, et al. PreEclampsia: It’s Effect on Renal, Cardiovascular, Hepatic and Thyroid Functions a Review. Am J Clin Med Res. 2014;2(6):111-3.
Soomro N, Shazia. Serum uric acid as a protector model for preeclampsia. Park J Surg. 2010;26(3):246-51.
Laughon SK, Cator J, Powers RW, Roberts JM, Gandley RE. First trimester uric acid and adverse pregnancy outcomes. Am J Hypertension. 2011;24(4):489-95.
Cheung KL, Lafayette RA. Renal physiology of pregnancy. PMC. 2014;20(3):209-14.
Khurshid R, Shamsi A, Fayyaz I, Zia M. Maternal serum uric acid level during pregnancy: a marker for preeclampsia. PJMHS. 2016;2(10):1-25.
Buzanovskii VA. Estimation of serum uric acid in blood. Ref J Chem. 2015;5(1):281-323.
Hawkins TL, Roberts JM, Mangos GJ, Davis GK, Roberts LM, Brown MA. Plasma uric acid remains a marker of poor outcome in hypertensive pregnancy: a retrospective corhot study. BJOG. 2012;119(4):484-92.
Siemons JMBL. The uric content of maternal and fetal blood. J Biol Chem. 1917;32:63-9.
Fay RA. Uric acid in pregnancy and preeclampsia: an alternative hypothesis. Aust NZI Obstet Gynecol. 1990;30(2):141-2.
Zhao Y, Yang X, Lu W, Liao H, Liao F. Uricase based methods for determination of uric acid in serum. Microchimica Acta. 2009;164(1):1-6.
Vyakaranam S, Bhongir AV, Patlolla D, Chuntapally R. Study of serum uric acid and creatinine in hypertensive disorders of pregnancy. Int J Med Sci Public Health. 2015;4(10):1424-8.
Wu Y, Xiong X, Fraser WD, Luo Z. Association of uric acid with progression of preeclampsia and development of adverse conditions in gestational hypertensive pregnancies. Am J Hypertens. 2012;25(6):711-7.
Talaulikar VS, Shehata H. Uric acid: is it time to give up routine testing in management of preeclampsia? Obstet Med. 2012;5(3):119-23.
Jaykaran C, Biswas T. How to calculate sample size for different study designs in medical research. Indian J Psychol Med. 2013.35(2):121-6.
Nwankwo AA, Chukwuemeka EH, Ezeama MC, Ijioma SN. Study of serum uric acid, BMR, BP and Urine protein levels in Preeclampsia of pregnancy. J Med Dent Sci Res. 2016;3(6):23-7.
Umeora OUJ, Esike COU, Eze JN. Preeclampsia/Eclampsia. The Guide: Protocols for management of the Obstetrics and Gynaecological patient in the tropics-1st edition. Uncle-Chyk concepts. 2017.
Manjareeka M, Nanda S. Elevated levels of serum uric acid, creatinine or urea in Preeclamptic women. Int J Med Sci Public Health. 2013;2(1)43.
Bellomo G, Venanzi S, Saronio P, Verdura C, Narducci PL. Prognostic significance of serum uric acid in women with gestational hypertension. Hypertension. 2011;58(4):704-8.
Tejal P, Astha D. Relationship of serum uric acid level to maternal and perinatal outcome in patients with hypertensive disorder of pregnancy. Gujarat Med J. 2014;69(2):45-7.
Niraula A, Lamsal M, Majhi S, Khan SA, Basnet P. Significance of uric acid in pregnancy induced hypertension. J Nat Med Assoc. 2017;109(3):198-202.
Enaruna NO, Idemudia J, Aikanogie PI. Serum lipid profile and uric acid levels in preeclampsia in university of Benin teaching Hospital. NMJ. 2014;55(5):423-7.
Akter S, Sultana S, Dabee SR. Association of hyperuricaemia with perinatal outcome in pregnancy induced hypertension. Jour of Bangladesh College Phy and Surg. 2014;32(3):124-9.
Lim k, Friedman SA, Ecker JL, Kao L, Kilpatrick SJ. The clinical utility of serum uric acid measurements in hypertensive diseases of pregnancy. AJOG. 1998;178(5):1067-71.