Serum uric acid as a prognostic marker for preeclampsia at a tertiary hospital in Port Harcourt, Nigeria

Background: Preeclampsia is a recognized cause of maternal and perinatal morbidity and mortality. Some biomarkers such as uric acid are increased in the presence of the disease. This could serve as a marker of severity and provide a basis for making management decisions. This study sought to determine the association between elevated serum uric acid and adverse pregnancy outcomes in preeclampsia.Methods: A prospective case-control study was carried out on consenting preeclamptic (95) and normotensive (95) pregnant women in their third trimester of pregnancy. Blood samples were taken for serum uric acid estimation at recruitment and delivery. Their Socio-demographic information was collected through a structured proforma. Data were analyzed using Statistical package for social sciences (SPSS) version 23. A p<0.05 was considered statistically significant.Results: The mean serum uric acid level was higher in the preeclamptic than in the normotensive controls (400.0±105.27 versus 256.31±67.18; p=0.001). High serum uric acid levels were associated with a higher incidence of AKI (p=0.005), birth asphyxia (p=0.002), and low birth weight (p=0.006) compared to preeclamptics with normal uric acid levels. The sensitivity of high uric acid in predicting the outcomes was 78-81% while the specificity was 48%. Serum uric acid ≥334 µmol/l was the threshold for predicting adverse outcomes.Conclusions: Women with preeclampsia had significantly higher serum uric acid levels. Hyperuricaemia in preeclampsia was associated with a high incidence of acute kidney injury, Birth asphyxia, and low birth weight. Serum uric acid ≥334 µmol/l was the threshold for the prediction of adverse outcomes.