The clinical utility of serum uric acid measurements in pre-eclampsia and transient hypertension in pregnancy

Background. Our purpose was to evaluate the clinical utility of serum uric acid measurements in the hypertension diseases of pregnancy. Methods. We identified 286 women and categorized them into three diagnostic groups according to definitions of hypertensive diseases in pregnancy publ ished by the National Working Group on Hypertension in Pregnancy: pre-eclam psia (94), transient hypertension (102) and normal (90). We compared the me dian uric acid concentration for each group and calculated the sensitivitie s and the specificities in diagnosing pre-eclampsia. The results were analy zed by the Mann-Whitney test. Results. Median serum uric acid values in the pre-eclamptic group, in the t ransient hypertension group and in the control group were 375 (262-536) mu mol/L, 309 (214-387) mu mol/L, 259 (143-339) mu mol/L, respectively. Compar ed with normal, the median serum uric acid levels in women with pre-eclamps ia or transient hypertension were significantly elevated. Differences in me dian serum uric acid concentrations between women with preeclampsia and wit h transient hypertension were statistically significant too. The prevalence of IUGR in the pre-eclamptic group and transient hypertension group was 65 .9% and 29.4%,respectively. Sensitivity for serum uric acid levels of 339 m u mol/L was 77.3% in the pre-eclamptic group and 32.3% in the transient hyp ertension group; the difference was statistically significant. Specificity was exactly the same in both groups (92%). Conclusions. Our data, in accordance with international literature, confirm the clinic al utility of serum uric acid as a marker of pre-eclampsia, but not of transient hypertension. Furthermore its high predictive value makes it possible to select a group of pre-eclamptic women with high risk for in trauterine growth retardation.