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Jummaat F, Adnan AS, Ab Hamid SA, Hor JN, Nik Mustofar NN, Muhammad Asri NA, Wan Mohd Aminuddin WI, Wan Zalik WEA, Azmi NFA, Che Hasnan NA. Foetal and maternal outcomes in hyperuricaemia pre-eclampsia patients in Hospital Universiti Sains Malaysia. J OBSTET GYNAECOL 2020; 41:38-43. [PMID: 33124936 DOI: 10.1080/01443615.2019.1679731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Preeclampsia patients have frequently been found to experience hyperuricaemia and this may result in poor outcomes compared to those with normal uric acid levels. This study aimed to determine the relationship of hyperuricaemia in pre-eclampsia patients with foetal and maternal outcomes. This prospective cohort study involved 79 patients in a tertiary centre from year 2016 to 2018. Blood samples were taken antenatally and at the 6th week, post-delivery for renal function including serum uric acid level. Our findings indicate that there was a higher incidence of poor maternal and foetal outcomes in the hyperuricaemia group than the normal uric acid group. Serum uric acid has been shown to be a significant predictor for low birth weight and premature delivery in preeclampsia patients. It was also found that there was a significant negative correlation between uric acid level and antenatal creatinine clearance (rs = -0.338, p = .002). The assessment of the serum uric acid level seems to be important to ensure better outcomes in patients with preeclampsia.Impact statementWhat is already known on this subject? Preeclampsia is a serious pregnancy-related complication and remains as one of the most important cause of maternal and foetal morbidity and mortality, affecting 2-8% in all pregnancy. Many studies have established the association between hyperuricaemia and preeclampsia. Besides, numerous studies have found that hyperuricaemia contributed to adverse maternal and foetal outcomes.What the results of this study add? There was a significant increase in adverse foetal and maternal outcomes in the hyperuricaemia group compared to the normal uric acid group. This study revealed that serum uric acid remains a significant predictor for low birth weight and premature delivery in preeclampsia patients.What the implications are of these findings for clinical practice and/or further research? Hyperuricaemia does not merely become an indicator for the severity of disease in preeclampsia patients but also indicates adverse foetal outcomes. Large population-based studies are required to establish the absolute maternal and foetal outcomes in patients with hyperuricaemia. Besides, further studies are recommended on long-term implication of hyperuricaemia which is not limited to only during antenatal period.
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Affiliation(s)
- Fauziah Jummaat
- Department of Obstetrics & Gynaecology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.,Management and Science University Medical Centre, Shah Alam, Selangor, Malaysia
| | - Azreen Syazril Adnan
- Management and Science University Medical Centre, Shah Alam, Selangor, Malaysia.,CKD Resource Center, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Siti Azrin Ab Hamid
- Department of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Jie Ning Hor
- CKD Resource Center, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Nik Nurdinie Nik Mustofar
- CKD Resource Center, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Nur Asmarina Muhammad Asri
- CKD Resource Center, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | | | | | - Nur Farha Adnin Azmi
- CKD Resource Center, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Nur Adilah Che Hasnan
- CKD Resource Center, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
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Jiang L, Zhou Y, Huang Q. Serum fibroblast growth factor 21 level is increased in pre-eclampsia patients: Association with blood pressure and lipid profile. J Obstet Gynaecol Res 2020; 47:375-381. [PMID: 33073442 DOI: 10.1111/jog.14534] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 08/10/2020] [Accepted: 10/03/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Pre-eclampsia (PE) is dangerous complication, which leads to adverse pregnancy outcomes. AIMS The study was to explore the correlation between serum level of fibroblast growth factor (FGF) 21 and PE. METHODS A total of 80 cases were involved in this study containing PE group (49 cases) and control group (31 cases, normal pregnancy). PE group was divided into early-onset PE (EOPE) and late-onset PE (LOPE). Serum level of FGF21 and biochemical parameters were measured before delivery. RESULTS Maternal serum FGF21 level was higher in PE especially in EOPE than that in control groups (P < 0.05). In PE patients, serum FGF21 level was positively correlated with mean arterial pressure, diastolic blood pressure and low-density lipoprotein cholesterol (P < 0.05). Levels of FGF21, uric acid and low-density lipoprotein cholesterol were risk factors for PE. CONCLUSION Maternal serum FGF21 level in PE particularly in EOPE was higher and was associated with blood pressure and lipid profile.
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Affiliation(s)
- Lin Jiang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Department of Obstetrics and Gynecology, , Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yang Zhou
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Qin Huang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Soochow University, Suzhou, China
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Pecoraro V, Trenti T. Predictive value of serum uric acid levels for adverse maternal and perinatal outcomes in pregnant women with high blood pressure. A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2020; 252:447-454. [PMID: 32736271 DOI: 10.1016/j.ejogrb.2020.07.042] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/18/2020] [Accepted: 07/21/2020] [Indexed: 02/01/2023]
Abstract
OBJECTIVE High serum uric acid seems to be associated with pre-eclampsia. The expected utility of uric acid is related to the probability of occurrence of maternal and neonatal complications. We evaluated the accuracy of uric acid in predicting adverse maternal and perinatal outcomes in pregnant women with high blood pressure. METHODS We performed an electronic search for studies evaluating the accuracy of high serum uric acid levels in pregnant women with high blood pressure. The assessment of risk of bias was performed using the QUIPS tool. For each included study, we collected data about study characteristics and diagnostic test accuracy to construct 2 × 2 tables. Pooled sensitivity (Se), specificity (Sp) and diagnostic odds ratio (DOR) were estimated using a bivariate model. Grading the quality of the evidence was assessed using the GRADE approach. RESULTS Twenty-one studies, testing more than 6,000 women, met the inclusion criteria. The majority of studies were at low risk of bias. Ten studies evaluated the role of serum uric acid to predict pre-eclampsia, the pooled Se was 0.74 (95%CI 0.71-0.77), Sp was 0.66 (95%CI 0.63-0.68), and DOR was 9.67 (95%CI 4.57-20.47). The overall quality of evidence was evaluated as low. The GRADE rating was downgraduate for risk of bias and inconsistency. CONCLUSIONS No robust evidence currently exists to suggest that uric acid measurement is useful in predicting maternal and perinatal adverse outcomes.
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Affiliation(s)
- Valentina Pecoraro
- Department of Laboratory Medicine, OCSAE, Azienda USL of Modena, Via Pietro Giardini 1355, 41126, Modena, Italy.
| | - Tommaso Trenti
- Department of Laboratory Medicine, OCSAE, Azienda USL of Modena, Via Pietro Giardini 1355, 41126, Modena, Italy.
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Khaliq OP, Konoshita T, Moodely J, Ramsuran V, Naicker T. Gene polymorphisms of uric acid are associated with pre-eclampsia in South Africans of African ancestry. Hypertens Pregnancy 2020; 39:103-116. [PMID: 32255363 DOI: 10.1080/10641955.2020.1741608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objectives: To investigate the association of uric acid gene polymorphisms and Pre-eclampsia.Methods: 637 women of African ancestry [280 controls, 357 pre-eclampsia (early-onset = 187, late-onset = 170]) retrospectively. The rs505802, rs1212986, and rs1014290 SNPs were genotyped from purified DNA using real-time PCR.Results: CT genotype (rs505802) was higher in pre-eclampsia [Adjusted p = 0.028*: OR (95% CI) = 1.73 (1.258-2.442)] and late-onset pre-eclampsia [Adjusted p = 0.027*: OR (95% CI) = 1.75 (1.165-2.2628)] than controls. CT genotype (rs1014290) was higher in early-onset pre-eclampsia [Adjusted p-value = 0.040*: OR (95% CI) = 1.60 (1.102-2.325)] than controls.Conclusion: The genotyped rs505802 and rs1014290 are significantly associated with pre-eclampsia.
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Affiliation(s)
- Olive P Khaliq
- Optics and Imaging Centre, Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa
| | - Tadashi Konoshita
- Third Department of Internal Medicine, University of Fukui Faculty of Medicine Sciences, Fukui, Japan
| | - Jagidesa Moodely
- Department of Obstetrics and Gynecology and Women's Health and HIV Research Group, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Veron Ramsuran
- KwaZulu-Natal Research Innovation and Sequencing Platform, School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Thajasvarie Naicker
- Optics and Imaging Centre, Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa
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Zhang J, Li J. Efficacy and safety of combination of magnesium sulfate, phentolamine and nifedipine in treatment of patients with hypertensive disorder complicating pregnancy. Exp Ther Med 2019; 18:3341-3346. [PMID: 31602207 PMCID: PMC6777338 DOI: 10.3892/etm.2019.7965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 07/01/2019] [Indexed: 12/22/2022] Open
Abstract
Efficacy and safety of the combination of magnesium sulfate, phentolamine and nifedipine in the treatment of patients with hypertensive disorder complicating pregnancy (HDCP) and its effect on hemodynamics and urinary protein level were investigated. One hundred and six patients with HDCP diagnosed at the Affiliated Hospital of Beihua University from February 5, 2016 to May 9, 2017 were retrospectively analyzed. Patients were divided into the magnesium sulfate group and the combination group, according to the therapeutic schemes. The efficacy 1 week later was observed. The general clinical data of the patients were recorded, and data were acquired with respect to hemodynamic indexes before and after treatment [changes of S/D ratio of umbilical artery flow, and cardiac index and total peripheral resistance (TPR)], the 24-h urinary protein level, clinical efficacy and safety [adverse drug reactions (ADR) and maternal and neonatal outcomes]. Before treatment, there was no statistically significant difference between the two groups in terms of S/D ratio of umbilical artery flow (P>0.05), while after treatment the S/D ratio was significantly lower than that before treatment in both groups (P<0.05). Before treatment, there was no statistically significant difference between the two groups in terms of cardiac index (P>0.05). TPR after treatment was significantly lower than that before treatment in both groups (P<0.001). Compared with the magnesium sulfate group, patients in the combination group had significantly lower 24-h urinary protein level after treatment (P<0.001), significantly higher total effective rate (P<0.05), significantly lower incidence rate of ADR (P<0.001), and significantly lower incidence rate of adverse maternal and neonatal outcomes (P<0.001). In conclusion, the combination of magnesium sulfate, phentolamine and nifedipine can significantly improve the hemodynamic indexes, the 24-h urinary protein level, the clinical efficacy, ADR and maternal and neonatal outcomes of patients with HDCP, therefore it is worthy of use in the clinic.
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Affiliation(s)
- Jinggui Zhang
- Department of Cardiovascular Medicine, Affiliated Hospital of Beihua University, Jilin 132001, P.R. China
| | - Jun Li
- Screening Laboratory, Jilin Hospital for Gynecology and Obstetrics, Jilin 132011, P.R. China
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Maternal serum uric acid and calcium as predictors of hypertensive disorder of pregnancy: A case control study. Taiwan J Obstet Gynecol 2019; 58:244-250. [PMID: 30910147 DOI: 10.1016/j.tjog.2019.01.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2018] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES Compare serum uric acid and calcium levels among normotensive and hypertensive pregnant women, to compare maternal and perinatal outcomes in two groups. MATERIALS AND METHODS Prospective case control study was conducted after ethical approval in Obstetrics and Gynaecology department of rural tertiary care centre of Northern India, over seven months. Total 220 antenatal women ≥34 weeks of gestation with 110 cases having hypertensive disorder of pregnancy and 110 controls with normal blood pressure were compared for maternal uric acid and calcium levels and maternal, perinatal outcomes. RESULTS Mean ± SD values of uric acid and calcium in control group was 4.42 ± 1.42 mg/dl and 8.94 ± 0.6 mg/dl, whereas in cases they were 6.8 ± 2.72 mg/dl and 8.61 ± 0.78 mg/dl (p < 0.05). Induced labour followed by lower segment caesarean section was the most common mode of delivery in hypertensive cases, whereas, in controls, the majority had spontaneous onset of labour and delivered vaginally (p < 0.05). Hypertensive women with higher uric acid and lower calcium had adverse perinatal outcome as compared to controls (p < 0.05). Mean ± SD of neonatal birth weight in controls was 2.81 ± 0.295 Kg and in cases 2.56 ± 0.421 Kg. Neonatal birth weight was significantly associated with maternal uric acid than calcium in hypertensive women. Cases with hyperuricemia and low calcium levels had adverse overall outcome as compared to controls. CONCLUSION Maternal hyperuricemia and hypocalcaemia was associated with adverse maternal, perinatal outcomes in women with hypertensive disorder of pregnancy as compared to healthy normotensive women.
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