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Int J Med Sci 2024; 21(9):1612-1621. doi:10.7150/ijms.95313 This issue Cite

Research Paper

Elevated serum uric acid to creatinine ratio is associated with adverse pregnancy outcomes: a prospective birth cohort study

Enjie Zhang^1,*, Shaofei Su^1,*, Shen Gao¹, Yue Zhang², Jiajia Wang^3,4, Jianhui Liu¹, Shuanghua Xie¹, Jinghan Yu¹, Qiutong Zhao¹, Wentao Yue^2,4,✉, Ruixia Liu^1,4,✉, Chenghong Yin^1,4,✉

1. Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital. Beijing, China.
2. Department of Research Management, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital. Beijing, China.
3. School of Public Health, Capital Medical University, Beijing, China.
4. Laboratory for Gene-Environment and Reproductive Health, Laboratory for Clinical Medicine, Capital Medical University, Beijing, China.
*These authors have contributed equally to this work and share first authorship.

✉ Corresponding author: Chenghong Yin, Email: yinchhedu.cn; Address: No. 251 Yaojiayuan Road, Chaoyang District, Beijing, China, 100026; Tel.: +86 010 52275422. Ruixia Liu, Email: liuruixiaedu.cn; Address: No. 251 Yaojiayuan Road, Chaoyang District, Beijing, China, 100026; Tel.: +86 010 52277607. Wentao Yue, Email: yuewtedu.cn; Address: No. 251 Yaojiayuan Road, Chaoyang District, Beijing, China, 100026; Tel.: +86 010 85985110. More

Abstract

Purpose: This study evaluated the association between maternal serum uric acid-to-creatinine ratio (SUA/SCr) in the first trimester and adverse maternal and neonatal outcomes.

Methods: A prospective birth cohort study was conducted between 2018 and 2021. Logistic regression models and restricted cubic splines were utilized to estimate the associations between the SUA/SCr ratio and feto-maternal pregnancy outcomes. Women were stratified according to maternal age and pre-pregnancy body mass index.

Results: This study included 33,030 pregnant women with live singleton pregnancies. The overall prevalence of gestational diabetes mellitus (GDM), pregnancy-induced hypertension (PIH), cesarean delivery, preterm birth, large-for-gestational age (LGA), small-for-gestational age, and low Apgar scores were 15.18%, 7.96%, 37.62%, 4.93%, 9.39%, 4.79% and 0.28%, respectively. The highest quartile of SUA/SCr was associated with the highest risk of GDM (odds ratio [OR] 2.14, 95% CI 1.93-2.36), PIH (OR 1.79, 95% CI 1.58-2.04), cesarean delivery (OR 1.24, 95% CI 1.16-1.33), and preterm birth (OR 1.30, 95% CI 1.12-1.51). The associations between SUA/SCr with adverse pregnancy outcomes showed linear relationships except for GDM (P < 0.001 for all, P < 0.001 for non-linearity). Subgroup analyses revealed that the associations between the SUA/SCr ratio and the risks of PIH and LGA were significantly stronger in younger pregnant women (P = 0.033 and 0.035, respectively).

Conclusion: Maternal SUA/SCr levels were associated positively with the risk of adverse pregnancy outcomes. Timely monitoring of SUA and SCr levels during early pregnancy may help reduce the risk of adverse pregnancy outcomes and provide a basis for interventions.

Keywords: Serum uric acid, Serum uric acid-to-creatinine ratio, Adverse feto-maternal pregnancy outcomes

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