背景:全球,妊娠期高血压疾病(HDP)是孕产妇和胎儿发病和死亡的主要原因之一。血清尿酸是一种可以评估HDP严重程度以及相关母体和胎儿发病率和死亡率的测试。
目的:探讨孕妇血清尿酸水平与HDP严重程度及总体妊娠结局的关系。
方法:对孕龄>20周且血压>140/90mmHg3年的妇女进行了回顾性研究。总共134名患者被纳入研究。慢性高血压患者,没有高血压的高尿酸血症,其他重大疾病被排除在外。数据是从医疗记录中收集的,包括年龄,gravida,奇偶校验,体重,高度,胎龄,入院时的血压,尿白蛋白,和血清尿酸水平。
结果:在134名HDP患者中,76人患有妊娠期高血压,41人患有先兆子痫,17人患有子痫。妊娠期高血压患者的平均尿酸水平(mg/dL)分别为6.06±1.651、6.20±0.824和7.38±1.26,先兆子痫,和子痫,分别,这是一个显著的关联(p=0.002)。重症监护病房(ICU)患者的平均尿酸(mg/dL)为5.86±1.27,而病房患者为6.45±1.39(p=0.015)。在尿酸水平升高的患者中,ICU入院和早产的风险显著增加(r=-0.401,p<0.001)。低出生体重婴儿尿酸水平升高的风险显着增加(r=-0.278,p=0.001)。然而,尿酸水平升高的新生儿重症监护病房入院风险无统计学显著增加(p=0.264).
结论:血清尿酸水平在HDP中差异显著,在重度先兆子痫和子痫中升高。可以考虑根据疾病严重程度对HDP进行风险分层;但是,它在决定结果方面的作用是有争议的。在预测模型中使用血清尿酸水平以及已知的生物标志物可以确定其在疾病预测和严重程度中的可能附加价值。
BACKGROUND: Worldwide, hypertensive disorders of pregnancy (HDP) are among the leading causes of maternal and fetal morbidity and mortality. Serum uric acid is a test that can evaluate the severity of HDP and the associated maternal and fetal morbidity and mortality.
OBJECTIVE: To examine the relationship between maternal serum uric acid levels and the severity of HDP and overall pregnancy outcomes.
METHODS: A retrospective study was conducted on women with a gestational age > 20 weeks and BP >140/90 mmHg over three years. A total of 134 patients were included in the study. Patients with chronic hypertension, hyperuricemia without hypertension, and other major illnesses were excluded. Data were collected from medical records, including age, gravida, parity, weight, height, gestational age, blood pressure at admission, urine albumin, and serum uric acid levels.
RESULTS: Of the 134 enrolled women with HDP, 76 had gestational hypertension, 41 had preeclampsia, and 17 had eclampsia. Mean uric acid levels in mg/dL were 6.06±1.651, 6.20±0.824, and 7.38±1.26 in gestational hypertension, preeclampsia, and eclampsia, respectively, which was a significant association (p=0.002). Mean uric acid in mg/dL was 5.86±1.27 in intensive care unit (ICU) patients compared to 6.45±1.39 in ward patients (p=0.015). There was a significantly increased risk of ICU admission and preterm delivery (r=-0.401, p<0.001) in patients with elevated uric acid levels. There was a significantly increased risk of low-birth-weight babies with elevated uric acid levels (r=-0.278, p=0.001). However, there was no statistically significant increased risk of newborn intensive care unit admissions (p=0.264) with elevated uric acid levels.
CONCLUSIONS: Serum uric acid levels vary significantly in HDP and were found to be elevated in severe preeclampsia and eclampsia. It can be considered for risk stratification in HDP based on disease severity; however, its role in determining outcomes is debatable. Using serum uric acid levels in predictive models along with known biomarkers may determine its possible additional value in disease prediction and severity.