Prediction of maternal diabetes and adverse neonatal outcome in normotensive pregnancy using serum uric acid

Abstract

Diabetes mellitus, with adverse neonatal events are challenging issues to all obstetricians and pediatricians, where uric acid could play a vital role. We aimed to assess the relationship and prognostic benefits of serum uric acid measured at about 20 weeks’ gestation in normotensive pregnancy, with subsequent maternal diabetes, and neonatal complications.  All singleton normotensive pregnant women with normal blood glucose, serum creatinine, and weight before pregnancy, whom attended Medical City Hospital, Department of Obstetrics and Gynecology in Baghdad, were involved and regarded as the case group, on the condition that their serum uric acid measured at 20 weeks’ gestation > 3 mg/dl, but if ≤ 3 mg/dl, they would be registered as a control group. A complete follow up was performed regularly during pregnancy, and after delivery; regular assessments of maternal blood glucose were done up to one year. Maternal diabetes mellitus (DM), small for gestational age (SGA) neonates, and preterm delivery (PD) constituted (27.59%), (43.60%), and (1.97%), respectively in case group which had significantly included maternal DM and SGA (P <0.001).  Also, elevated mid-pregnancy serum uric acid was strongly associated (P <0.0001) with maternal DM (5.86 ± 0.69) and SGA (4.78 ± 0.34). Cut-off values of uric acid of 4.76 mg/dl were best associated with maternal DM, while 4.33 mg/dl with SGA.  In conclusion, the cut-off points of 4.76 and 4.33 mg/dl of maternal mid- normotensive pregnancy serum uric acid have the potential ability to predict Maternal DM and SGA, respectively.