CONICET | Buscador de Institutos y Recursos Humanos

Background Although the association between serum uric acid levels (sUA) and the severity of preeclampsia is well-known, its clinical utility is debated. Our hypothesis is that the periodic measurement of sUA during pregnancy might be useful to define a risk group before the onset of preeclampsia.AimsTo characterize the diagnostic performance of UA levels for the prediction of preeclampsia.MethodsA prospective study was designed to evaluate the behavior and the predictive value of sUA levels before and after the 20th week of gestation in all women who attended her pregnancy in the Hospital Dr. Prof. A. Posadas during 2014. Serum urea and creatinine were also measured. The uricemia ratio (uricemia measured after 20th week of gestation/uricemia measured before 20th week of gestation) was calculated. A ratio of sUA levels greater than 1.5 were considered as positive values for the analysis. Receiver operating curves (ROC) of sUA ratio were analyzed. The area under the curve (ROC area), the positive predictive value (PPV) and the negative predictive value (NPV) were studied.Results1125 women attended all their gestation at the Hospital Posadas. 810 were normal pregnancies while 40 developed preeclampsia and 8 fetal growth restriction (IUGR) without preeclampsia.sUA ratios were higher than 1.5 in early and late onset preeclampsia with or without IUGR. However, in those women who developed IUGR without preeclampsia, sUA ratios were lower than 1.5 suggesting that it may differentiate pure IUGR from IUGR and associated to preeclampsia.The ROC area for sUA ratios > 1.5 for preeclamptic pregnancies was 0.918 (0.858-0.979) with PPV and NPV of 19.2% and 99.5%, respectively. ConclusionssUA ratio shows a good NPV for monitoring women at risk for preeclampsia. Therefore, it is an economical and accessible tool that may be helpful to discard those pregnant women who are not at risk of suffering this syndrome.