Early pregnancy serum uric acid as an independent risk factor for pre-eclampsia: a retrospective nested case-control study
10.3760/cma.j.cn112141-20250429-00184
- VernacularTitle:妊娠早期血清尿酸对子痫前期的预测作用一项巢式病例对照研究
- Author:
Xue BAI
1
;
Tianjie LI
1
;
Yan LONG
1
Author Information
1. 首都医科大学附属北京友谊医院妇产科，北京 100050
- Publication Type:Journal Article
- Keywords:
Pregnancy trimester, first;
Uric acid;
Risk factors;
Forecasting;
Case-control studies;
Pre-eclampsia
- From:
Chinese Journal of Obstetrics and Gynecology
2025;60(9):700-708
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate whether elevated serum uric acid (UA) in early pregnancy was an independent risk factor for pre-eclampsia (PE) and its potential predictive value.Methods:This retrospective nested case-control study analyzed clinical data from pregnant women who delivered at Beijing Friendship Hospital, Capital Medical University, between January 2022 and March 2025. With the occurrence of PE as the outcome variable, the observation objects were divided into UA-elevated group and UA-normal group according to whether the UA level in the first trimester was higher than the 75th percentile ( P75) of the total population. After balancing confounders via propensity score matching (PSM), logistic regression, subgroup analysis and sensitivity analysis were performed to evaluate the association between UA and PE risk. Results:(1) In the initial cohort, the serum UA levels of PE women (327 cases) and non-PE women (8 919 cases) in the first trimester were (264.4±64.4) and (237.1±57.9) μmol/L, respectively, and the difference was statistically significant ( t=-4.74, P<0.001). The P75 of serum UA was 264.8 μmol/L, and based on this cut-off value, 7 169 cases (77.5%, 7 169/9 246) were in the UA-normal group and 2 077 cases (22.5%, 2 077/9 246) in the UA-elevated group. After PSM matching, the two groups were balanced in age, body mass index and other covariates. The incidence of PE in the UA-normal group and the UA-elevated group was 2.76% (198/7 169) and 6.21% (129/2 077); the incidence of severe PE was 1.21% (87/7 169) and 3.42% (71/2 077), respectively; the incidence of early-onset PE was 0.49% (35/7 169) and 1.44% (30/2 077), respectively; and the differences between the two groups were statistically significant (all P<0.001). (2) Logistic regression analysis showed that indirect bilirubin, low-density lipoprotein cholesterol, plateletcrit and UA (categorical and continuous variable forms) were independent risk factors for PE (all P<0.05), among which UA had the most significant risk effect with dose-effect trend. (3) For every 10 μmol/L increase in UA level, the risk of early-onset PE increased by 3% ( OR=1.03, 95% CI: 1.00-1.06; P=0.023), and the risk of severe PE increased by 5% ( OR=1.05, 95% CI: 1.01-1.09; P=0.012). (4) Multivariate logistic analysis showed that taking P70, P75 and P80 as cut-off values, the risk of PE increased by 40% ( OR=1.40, 95% CI: 1.02-2.13; P=0.047), 86% ( OR=1.86, 95% CI: 1.08-3.22; P=0.026), 87% ( OR=1.87, 95% CI: 1.21-2.91; P=0.005), respectively. Conclusion:Elevated UA level in the first trimester of pregnancy is an independent risk factor for PE, which can be used as one of the early screening indicators to assist in identifying high-risk groups of PE.
