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Abstract：
BACKGROUND: Elevated maternal serum uric acid (UA) levels were associated with adverse perinatal outcomes. This study aimed to examine the association between UA and the risk of low birth weight (LBW) / small for gestational age (SGA).
METHODS: A cohort study of women delivered in Shanghai maternity hospital was included between 2017 and 2021. Electronic medical records were utilized to extract information and antenatal care records. The cut-off value of UA was 360 μmol/L. The outcome was LBW/SGA, with LBW defined as birth weight below 2500 g and SGA indicating birth weight below the 10th percentile of average weight for gestational age. The assessment of SGA was based on the Chinese standard curve for birth weight at various gestational ages. Univariate, multivariate logistic regression models, restricted cubic spline were used in this study, with adjustments made for confounding factors.
RESULTS: Sixty-nine thousand six hundred seventy-four live births and singleton pregnancies were included. The ratio of LBW/SGA was 3.3%/9%. Maternal UA levels were significantly negatively correlated with birth weight. High UA levels were associated with high risk of LBW/SGA, especially in third trimester. In BMI < 25 group, the risk of LBW increased to 2.35-fold (95%CI, 1.66-3.31) in hyperuricemic group (UA > 360 μmol/L). The SGA risk was 1.66-fold (95%CI, 1.37-2.00). Gestational hypertension (GH) with hyperuricemica increased the risk of LBW (aOR = 4.00, 95%CI, 2.01-7.93) and SGA (aOR = 2.63, 95%CI, 1.83-3.78). Preeclampsia (PE) with hyperuricemia increased the risk of LBW (aOR = 1.38, 95%CI, 0.63-3.03) and SGA (aOR = 1.81, 95%CI, 1.18-2.78). In delivery gestational week (DGW) ≥ 37 group, if UA > 360 μmol/L, the incidence of LBW increased to 2.46-fold (95%CI, 1.62, 3.73) and the incidence of SGA increased to 1.52-fold (95%CI, 1.24, 1.87). In DGW < 37 group, if UA > 360 μmol/L, the incidence of LBW increased to 2.70-fold (95%CI, 1.92, 3.80) and the incidence of SGA increased to 2.13-fold(95%CI, 1.50, 3.02).
CONCLUSIONS: The study found an inverse correlation between UA levels and birth weight. High UA levels were associated with increased risk of LBW/SGA, particularly in third trimester. GH or PE complicated by hyperuricemia were found to have significantly higher risk of developing LBW/SGA. This relationship also existed in pregnant women with BMI < 25.
METHODS: A cohort study of women delivered in Shanghai maternity hospital was included between 2017 and 2021. Electronic medical records were utilized to extract information and antenatal care records. The cut-off value of UA was 360 μmol/L. The outcome was LBW/SGA, with LBW defined as birth weight below 2500 g and SGA indicating birth weight below the 10th percentile of average weight for gestational age. The assessment of SGA was based on the Chinese standard curve for birth weight at various gestational ages. Univariate, multivariate logistic regression models, restricted cubic spline were used in this study, with adjustments made for confounding factors.
RESULTS: Sixty-nine thousand six hundred seventy-four live births and singleton pregnancies were included. The ratio of LBW/SGA was 3.3%/9%. Maternal UA levels were significantly negatively correlated with birth weight. High UA levels were associated with high risk of LBW/SGA, especially in third trimester. In BMI < 25 group, the risk of LBW increased to 2.35-fold (95%CI, 1.66-3.31) in hyperuricemic group (UA > 360 μmol/L). The SGA risk was 1.66-fold (95%CI, 1.37-2.00). Gestational hypertension (GH) with hyperuricemica increased the risk of LBW (aOR = 4.00, 95%CI, 2.01-7.93) and SGA (aOR = 2.63, 95%CI, 1.83-3.78). Preeclampsia (PE) with hyperuricemia increased the risk of LBW (aOR = 1.38, 95%CI, 0.63-3.03) and SGA (aOR = 1.81, 95%CI, 1.18-2.78). In delivery gestational week (DGW) ≥ 37 group, if UA > 360 μmol/L, the incidence of LBW increased to 2.46-fold (95%CI, 1.62, 3.73) and the incidence of SGA increased to 1.52-fold (95%CI, 1.24, 1.87). In DGW < 37 group, if UA > 360 μmol/L, the incidence of LBW increased to 2.70-fold (95%CI, 1.92, 3.80) and the incidence of SGA increased to 2.13-fold(95%CI, 1.50, 3.02).
CONCLUSIONS: The study found an inverse correlation between UA levels and birth weight. High UA levels were associated with increased risk of LBW/SGA, particularly in third trimester. GH or PE complicated by hyperuricemia were found to have significantly higher risk of developing LBW/SGA. This relationship also existed in pregnant women with BMI < 25.
摘要：
背景：孕妇血清尿酸（UA）水平升高与不良围产期结局相关。这项研究旨在研究UA与低出生体重（LBW）/小于胎龄（SGA）风险之间的关系。
方法：纳入2017年至2021年在上海妇产医院分娩的妇女的队列研究。电子病历用于提取信息和产前护理记录。UA的截断值为360μmol/L。结果是LBW/SGA，LBW定义为出生体重低于2500g，SGA表示出生体重低于胎龄平均体重的10百分位数。SGA的评估基于不同胎龄的中国出生体重标准曲线。单变量,多元逻辑回归模型，在这项研究中使用了有限的三次样条，针对混杂因素进行了调整。
结果：纳入六万九千六百七十四例活产和单胎妊娠。LBW/SGA的比率为3.3%/9%。母亲UA水平与出生体重呈显著负相关。高UA水平与LBW/SGA的高风险相关，尤其是在妊娠晚期.在BMI<25组中，高尿酸血症组(UA>360μmol/L)发生LBW的风险增加到2.35倍(95CI,1.66-3.31)。SGA风险为1.66倍（95CI，1.37-2.00）。妊娠期高血压（GH）伴高尿酸血症增加了LBW（aOR=4.00，95CI，2.01-7.93）和SGA（aOR=2.63，95CI，1.83-3.78）的风险。子痫前期（PE）合并高尿酸血症会增加LBW（aOR=1.38，95CI，0.63-3.03）和SGA（aOR=1.81，95CI，1.18-2.78）的风险。分娩孕周（DGW）≥37组，如果UA>360μmol/L，LBW的发生率增加到2.46倍(95CI,1.62,3.73),SGA的发生率增加到1.52倍(95CI,1.24,1.87).在DGW<37组中，如果UA>360μmol/L，LBW的发生率增加到2.70倍(95CI,1.92,3.80),SGA的发生率增加到2.13倍(95CI,1.50,3.02).
结论：研究发现UA水平与出生体重呈负相关。高UA水平与LBW/SGA风险增加相关，特别是在妊娠晚期。发现GH或PE并发高尿酸血症的发生LBW/SGA的风险明显更高。这种关系在BMI<25的孕妇中也存在。
方法：纳入2017年至2021年在上海妇产医院分娩的妇女的队列研究。电子病历用于提取信息和产前护理记录。UA的截断值为360μmol/L。结果是LBW/SGA，LBW定义为出生体重低于2500g，SGA表示出生体重低于胎龄平均体重的10百分位数。SGA的评估基于不同胎龄的中国出生体重标准曲线。单变量,多元逻辑回归模型，在这项研究中使用了有限的三次样条，针对混杂因素进行了调整。
结果：纳入六万九千六百七十四例活产和单胎妊娠。LBW/SGA的比率为3.3%/9%。母亲UA水平与出生体重呈显著负相关。高UA水平与LBW/SGA的高风险相关，尤其是在妊娠晚期.在BMI<25组中，高尿酸血症组(UA>360μmol/L)发生LBW的风险增加到2.35倍(95CI,1.66-3.31)。SGA风险为1.66倍（95CI，1.37-2.00）。妊娠期高血压（GH）伴高尿酸血症增加了LBW（aOR=4.00，95CI，2.01-7.93）和SGA（aOR=2.63，95CI，1.83-3.78）的风险。子痫前期（PE）合并高尿酸血症会增加LBW（aOR=1.38，95CI，0.63-3.03）和SGA（aOR=1.81，95CI，1.18-2.78）的风险。分娩孕周（DGW）≥37组，如果UA>360μmol/L，LBW的发生率增加到2.46倍(95CI,1.62,3.73),SGA的发生率增加到1.52倍(95CI,1.24,1.87).在DGW<37组中，如果UA>360μmol/L，LBW的发生率增加到2.70倍(95CI,1.92,3.80),SGA的发生率增加到2.13倍(95CI,1.50,3.02).
结论：研究发现UA水平与出生体重呈负相关。高UA水平与LBW/SGA风险增加相关，特别是在妊娠晚期。发现GH或PE并发高尿酸血症的发生LBW/SGA的风险明显更高。这种关系在BMI<25的孕妇中也存在。
