UTILITY OF THE APPLICATION OF THE PROBABILITY RATIO OF THE EVOLUTION OF URIC ACID LEVELS DURING PREGNANCY IN THE ASSIGNMENT OF RISK OF GESTATIONAL HYPERTENSIVE DISEASE

COROMINAS ANA; BALCONI SILVIA; RUIZ, JULIETA; FERREIROS, ALBERTO; CASALE, ROBERTO; DAMIANO ALICIA E

Mar del Plata

Congreso; Reunion Anual de las Sociedades de Biociencias; 2022

Clinical decision-making involves the appropriate application of evidence-based medicine and involves a numerical method for calculating risks. This method includes pretest risks (obstetric and anthropometric history) and biochemical analyzes (or any other test in which performance parameters are known). Identification of pregnant women at risk of preeclampsia is still a challenge. Biomarkers available involve highly complex equipment and, in most cases, they have a short-term predictive role. In contrast, uric acid levels show an interesting diagnostic performance for preeclampsia being its dosage simple and accessible. Objective: to analyze the uric acid diagnostic attributes in pregnant women with different pretest risks, to estimate the risk of suffering gestational hypertensive disorders.Methods: Retrospective study. We analyzed the Positive and negative likelihood ratios (LR+, LR?) for the uricemia ratio (uricemia after and before the 20th week of gestation) and the incidence of gestational disorders. The post-test risks were calculated by interpolating in the Fagan diagram based on the pretest risk established in the guide for the diagnosis and treatment of hypertension in pregnancy (national ministry of health). Results: Using the pretest risk values based on the obstetric history, and the performance parameters of the uricemia ratio with a cut-off value of 1.5,the post-test values (when the uricemia ratio was≥1.5) obtained were 0.54 for preeclampsia in a previous pregnancy; 0.34 for Diabetes type 1 or 2; 0.03 for multiple pregnancies; 0.29 for the previous history of preeclampsia; 0.20 for maternal age > 40 years; 0.29 for nulliparity and0.18 for BMI > 3; and around 0.01 in general when the uricemia ratio was