The Role of Hyperuricemia as a Predictor of Adverse Perinatal Outcomes in Preeclamptic Women

Abstract

Aqsa Akram*

Background: Pre-eclampsia is a major cause of maternal and perinatal morbidity and mortality. Hyperuricemia is a common finding in pre-eclampsia, but its role as a predictor of adverse outcomes remains a subject of investigation.

Objective: To determine the association between elevated serum uric acid levels and adverse perinatal outcomes in women with pre-eclampsia.

Methods: A prospective cohort study was conducted from Nov 13, 2024, to April 22, 2025. A total of 272 pre-eclamptic women with a gestational age >24 weeks were enrolled and divided into two cohorts: the exposed group (serum uric acid ≥6 mg/dL, n=136) and the unexposed group (serum uric acid <6 mg/dL, n=136). The primary outcomes measured were severe pre-eclampsia, low birth weight (LBW), intrauterine growth restriction (IUGR), early neonatal death, NICU admission, and a 5-minute Apgar score <7. Data were analyzed using SPSS version 25, with Chi-square tests and relative risk (RR) calculations.

Results: Women with hyperuricemia had significantly higher rates of adverse outcomes. Severe pre-eclampsia occurred in 49.26% of the exposed group vs. 25.0% in the unexposed group (RR=1.97, p=0.0001). Similarly, the exposed group had higher incidences of LBW (36.76% vs. 9.56%; RR=3.86, p=0.0001), NICU admission (20.59% vs. 8.82%; RR=2.33, p=0.009), and early neonatal death (25.74% vs. 9.56%; RR=2.69, p=0.001). The association with IUGR and low Apgar score was not statistically significant.

Conclusion: Hyperuricemia (serum uric acid ≥6 mg/dL) in pre-eclamptic women is strongly associated with an increased risk of severe maternal disease and several adverse perinatal outcomes, including low birth weight, NICU admission, and early neonatal death. Serum uric acid measurement is a valuable, low-cost prognostic marker that can help identify high-risk pregnancies for more intensive management.

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