Uric acid levels in gestational hypertensive disorders and fetal growth restriction

Abstract

Objectives: To evaluate the levels of serum uric acid in pregnant womenwith fetal growth restriction associated or not with hypertensivedisorders.Methods: A retrospective descriptive-quantitative study was carried out inall women who attended their pregnancy at the Hospital Posadas during2014. Newborn of singleton pregnancies with fetal growth restriction(IUGR) and more than 22 weeks were studied. Uricemia ratio (uricemiaafter 20th week /uricemia before 20th week) was calculated in women whopresented IUGR associated or not to preeclampsia (PE) and gestationalhypertension (PIH).Results: In 3589 simple gestations analyzed, 100 presented PE (24 withIUGR), 208 PIH (19 with IUGR) and 3281 were normotensive (203 withIUGR).In the hypertensive group, the relative risk (RR) of having a newbornunder percentile 10 was 4.09(2.82-5.94) for PE and 1.72(1.12-2.64) for PIH.Regarding the evolution of pregnancy and birth, PE women have thehighest RR of prematurity, pathological Doppler, newborn weight <2500and requirement for neonatal intensive care at birth, while the RR foroligohydramnios was higher in PIH than in PE [2.1(1.02-3.94) vs 2.58 (1.45-4.60)]. Uricemia ratio was significantly increased in women with preeclampsia(1.77±0.28 in PE, 1.26±0.31 in PIH, 1.20±0.28 in normotensivewomen). The association between hypertension and IUGR increased theselevels (2.18±0.68 in PE and 1.6±0.50 in PIH). Uricemia ratio in normotensivewomen with IUGR was unchanged (1.21±0.29).Conclusion: Our results showed that normotensive pregnancies with orwithout growth restriction are not associated with an increase in uricemialevels. However, in gestational hypertensive disorders accompanying withfetal growth restriction the high increase in uricemia seems to be related toa more severe presentation of the maternal endothelial dysfunction. Thesefindings suggest that the etiology of the insufficient placentation in thesesyndromes may be different.