DIAGNOSTIC PERFORMANCE OF URIC ACID FOR PREDICTION OF PREECLAMPSIA

A. COROMINAS; S. BALCONI; M. ORTIZ; MARTÍNEZ N.; A. E. DAMIANO

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Simposio; Latin American Society for Maternal Fetal Interaction and Placenta; 2017

Although it is well-established the relationship between uric acid levels(UA) and preeclampsia, its clinical utility is still controversial.Objective: to characterize the diagnostic performance of UA for the predictionof preeclampsia.Methods:We conducted a prospective approach in which all patients whoattended her pregnancy in the Hospital Posadas during 2014 were studied.Serum UA, urea and creatinine were measured and evaluated throughoutgestation. Receiver operating curves (ROC) of the UA ratio between adosage before and after the 20th week of gestation and the ROC of proteinuriawere analyzed and compared. For ROC of UA, a ratio of _1.5 wasconsidered as a positive value.Results: We analyzed 480 normal pregnancies and 315 pathologicalpregnancies (40 preeclampsia, 23 gestational hypertension, 31 basal hypertension,140 diabetes, 71 premature births or premature rupture ofmembranes, 8 with intrauterine growth retardation and 2 with Lupus).The ROC area of UA for preeclamptic pregnancies was 0.872 (0.805-0.939)with positive and negative predictive values (PPV, NPV)) of 26% and 98.6%,respectively. In all cases, urea and creatinine showed normal values, confirmingthat patients had no renal compromise. The ROC area of positiveproteinuria was 0.823 (0.724-0.922) with PPV: 17.5% and NPV: 98.5%.When both determinations were included the ROC area was 0.871 (0.802-0.940) with PPV: 13.3% and NPV:99.3%.Conclusion: UA has a slightly better performance and a higher NPVthan proteinuria. Therefore, we suggest that a combination of the UAand proteinuria can be helpful to achieve a better prediction of preeclampsia.