Higher SUA to creatinine ratio ups risk of pre-eclampsia, adverse pregnancy outcomes

During pregnancy, a higher serum uric acid (SUA) to creatinine (sCr) ratio appears to elevate the risk of pre-eclampsia (PE) and adverse pregnancy outcomes, suggests a recent study.

“PE is one of the most severe diseases among the hypertensive disorders of pregnancy (HDP) and the leading cause of maternal and foetal morbidity and mortality,” the investigators said. “It is of crucial importance to early identify women at a high risk for PE to implement appropriate preventive strategies.”

In this study, the medical records of 269 women who consecutively attended an HDP clinic from December 2018 to December 2022 were searched for uric acid and creatinine values.

The investigators compared the baseline characteristics of participants with normotensive pregnancy (n=57) to those with HDP without PE (n=100) and with PE (n=112). They also conducted adjusted logistic regression analysis to examine the associations between SUA/sCr and the development of PE as well as maternal and neonatal complications.

Women with PE showed consistently higher SUA/sCr in all trimesters of their pregnancy.

After adjusting for age, body mass index prior to pregnancy, nulliparity, antihypertensive therapy, and acetylsalicylic acid therapy during pregnancy, higher SUA/sCr at the third trimester correlated with a greater chance of developing PE (odds ratio [OR], 1.29, 95 percent confidence interval [CI], 1.15‒1.50; p=0.001), preterm birth (OR, 1.23, 95 percent CI, 1.05‒1.45; p=0.011), and composite neonatal outcome (OR, 1.33, 95 percent CI, 1.12‒1.59; p=0.001).

“Controlled prospective studies are warranted to clarify the predictive power of this novel marker during pregnancy,” the investigators said.