significance of hyperuricemia in gestational hypertension and preeclampsia

ABSTRACT

Hyperuricemia [HU = serum uric acid >6mg/dl] seems to be related to the adverse perinatal outcomes in gestational hypertension [GH] and preeclampsia [PE]. The aim of our work is to verify this relation. A case-control study was performed on 50 normal pregnant patients, 69 cases of GH and 106 PE admitted to hospital for delivery. They were assigned into 7 categories 50 normal pregnancies, 38 cases of GH without HU, 31 cases of GH with HU 36 cases of mild PE without HU, 32 cases of mild PE with HU, 18 cases of severe PE without HU and 20 cases of severe PE with HU. All participants were primiparous with no known medical complications. Serum uric acid was estimated on admission for delivery in all categories. The frequency of preterm birth, gestational age at delivery, infant birth weight, rate of admission to the neonatal intensive care unit [NICU] and perinatal mortality were reported in the seven categories. Mean serum uric acid concentrations in normal pregnancy, GH, PE were 3.8 +/- 0.8 mg/dl, 6.9 +/- 0.6 mg/dl and 7.8 +/- 0.6 mg/dl respectively [P<0.001]. The systolic BP, diastolic BP, gestational age at delivery, infant birth weight admission to NICU and perinatal mortality [PNM] in different studied groups were in GH without HU and GH with HU were 148 +/- 6 vs 149 +/- 2 mmHg [P>0.05], 93 +/- 5 vs 94 +/- 6 mmHg [P>0.05], 39,2 +/- 2 vs 34,1 +/- 2 weeks [P<0.01], 3402 +/- 110 vs 2761 +/- 100 gm [P<0.01], 10.52 vs32.3% [P<0.05] and 0 vs 12,9% [P<0.05] respectively. In mild PE without HU and mild PE with HU the previous items were; 149 +/- 6.1 vs 150 +/- 4.8 mmHg [P>0.05],94 +/- 4.1 vs 96.28 mmHg [P>0.05], 38.6 +/- 2.1 vs 33.5 +/- 1.6 weeks [P<0.01],3044 +/- 096 vs 2762 +/- 101 gm [P<0.01].11.11 vs 43.75% [P<0.01] and 0 vs 6.25% [P>0.05] respectively. In severe PE without HU and severe PE with HU the previous items were 170 +/- 8.2 vs 172 +/- 3.1 mmHg [P>0.05], 110 +/- 6.8 vs12 +/- 8.8 mmHg [P>0.05], 36.8 +/- 1.1 vs 33.2 +/- 1.2 weeks [P<0.1], 2751 +/- 101 vs 2410 +/- 106 gm [P<0.01], 11.11 vs 40.0% [P<0.05] respectively. No relationship was found between the seric uric acid concentration and the severity of PE including the level of the blood pressure [BP], thrombocytopenia and the level of liver enzymes. However, there is a direct relation between HU and the adverse perinatal outcomes: lower gestational age at delivery, smaller birth weight and increased rate of admission to NICU, in GH and PE