Uric Acid Determination in Gestational Hypertension: Is it as Effective a Delineator of Risk as Proteinuria in High-Risk Women?

We asked, is uric acid as effective as proteinuria at identifying perinatal risk in high-risk women with gestational hypertension? Uric acid was measured in samples obtained4.6 weeks predelivery in 259 women with prior preeclampsia from the National Institute of Child Health and Human Development network study of low-dose aspirin to prevent preeclampsia. Participants were grouped according to the presence/absence of gestational hypertension (H), proteinuria (P), and hyperuricemia (U). Adverse perinatal outcomes were not different between H or U and women with normal values (normal blood pressure, urinary protein, and uric acid [NNN]). Preterm birth was greater in hypertension and proteinuria (HP) and hypertension and hyperuricemia (HU) compared to NNN (relative risk [RR] 2.4, P .03 and 3.8, P <.01), respectively. In addition, in HU women, delivery was earlier (36.6+ 3.4 vs 38.4+ 2.3 weeks, P <.001) and small for gestational age infants <fifth centile more frequent (RR 8.2, P .01) compared to NNN women. This study sought to determine if uric acid is as effective as proteinuria at identifying perinatal risk in high-risk women with gestational hypertension. Our results suggest that hyperuricemia is at least as accurate as proteinuria at identifying perinatal risk in high-risk women with gestational hypertension