The Predictive Role of Serum Uric Acid in Adverse Perinatal Outcomes Among Pre-eclamptic Women: A Prospective Cohort Study

Authors

DOI:

https://doi.org/10.54536/ajmhc.v1i1.6627

Keywords:

Cohort Study, Hyperuricemia, Low Birth Weight, NICU Admission, Perinatal Outcome, Pre-Eclampsia

Abstract

Pre-eclampsia is a major cause of maternal and perinatal morbidity and mortality. Hyperuricemia is a common finding in pre-eclampsia, but its role as a predictor of adverse perinatal outcomes remains a subject of investigation. To determine the association between high serum uric acid levels (≥6 mg/dL) and adverse perinatal outcomes in women with pre-eclampsia. A prospective cohort study was conducted from November 11, 2024, to May 10, 2025, at the Department of Obstetrics & Gynaecology, Fatima Memorial Hospital, Lahore. A total of 272 pre-eclamptic women with a gestational age >24 weeks were enrolled and divided into two groups: the exposed group (serum uric acid ≥6 mg/dL, n=136) and the unexposed group (serum uric acid <6 mg/dL, n=136). The primary outcomes measured were severe pre-eclampsia, low birth weight (LBW), intrauterine growth restriction (IUGR), early neonatal death, NICU admission, and an Apgar score <7 at 5 minutes. Data were analyzed using SPSS version 25, with Chi-square tests and relative risk (RR) calculations. The mean age of participants was 25.43 ± 4.29 years. Women in the hyperuricemic group had a significantly higher incidence of adverse outcomes: severe pre-eclampsia (49.26% vs. 25.0%; RR=1.97, p=0.0001), LBW (36.76% vs. 9.56%; RR=3.86, p=0.0001), NICU admission (20.59% vs. 8.82%; RR=2.33, p=0.009), and early neonatal death (25.74% vs. 9.56%; RR=2.69, p=0.001). The association for IUGR was not statistically significant (17.65% vs. 19.18%; p=0.754). High serum uric acid levels (≥6 mg/dL) in pre-eclamptic women are significantly associated with an increased risk of severe pre-eclampsia, low birth weight, NICU admission, and early neonatal death. Serum uric acid is a valuable, cost-effective biomarker for identifying high-risk pregnancies, warranting intensified monitoring and management to improve perinatal outcomes.

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Author Biography

  • Aqsa Akram, Senior Registrar Department of Obstetrics & Gynaecology, Fatima Memorial Hospital, Lahore, Pakistan

    My name is Dr. Aqsa Akram, and I am a triple-board–certified Obstetrician and Gynaecologist (MRCOG-UK, FACOG-USA, FCPS-Pakistan) with a strong academic foundation built on 14 Gold Medals during my MBBS and more than five years of progressive clinical experience. I currently serve as a Senior Registrar in Obstetrics & Gynaecology at Fatima Memorial Teaching Hospital, Lahore, where I lead high-risk obstetric care, advanced gynaecological procedures, and labour ward operations.
    Throughout my career, I have been deeply committed to delivering evidence-based, compassionate, and safe women’s healthcare. I have managed thousands of obstetric cases, supervised junior clinicians, and played a central role in improving labour ward protocols—contributing to reductions in severe maternal morbidity, unnecessary primary Caesarean sections, and delays in emergency surgical response times. My clinical experience ranges from complex obstetric emergencies to minimally invasive gynaecological surgery, including laparoscopic cystectomy, ectopic pregnancy management, hysterectomy, and urogynaecological procedures.
    I have always believed that a strong clinician must also be a lifelong learner. With this philosophy, I have completed more than 150 international courses, 300+ CME hours, and specialized training from leading global institutions including RCOG (UK), ACOG (USA), Stanford University, Brown University, the University of Tasmania, and the United Nations. This extensive exposure has strengthened my understanding of international standards in maternal safety, surgical excellence, and patient-centred care.
    Research and academic development hold a central place in my professional identity. I am the single author of multiple published research articles in international journals, covering themes such as maternal mental health, pre-eclampsia biomarkers, AI-based adnexal mass triage, neuro-inflammation in endometriosis, and tele-CBT for tokophobia. I have presented my work at national and international conferences and continue to expand my contributions in perinatal outcomes, maternal morbidity, and innovative models of women’s healthcare.
    I am passionate about teaching, mentoring, and shaping the next generation of clinicians. Over the years, I have supervised more than 50 postgraduate trainees and house officers, conducted weekly academic sessions, organized mock examinations, and contributed to curriculum-aligned training modules. I believe in building teams that are not only clinically sound but also empathetic and patient-centred.

References

Adewolu, O. F. (2013). Serum sodium, potassium, calcium and magnesium in women with pregnancy-induced hypertension and preeclampsia in a tertiary hospital in South West Nigeria. African Journal of Medicine and Health Sciences, 12(1), 1–5.

American College of Obstetricians and Gynecologists (ACOG). (2001). Diagnosis and management of preeclampsia and eclampsia. Obstetrics & Gynecology, 98(1), 159–167.

Bainbridge, S. A., & Roberts, J. M. (2008). Uric acid as a pathogenic factor in preeclampsia. Placenta, 29, S67–S72. https://doi.org/10.1016/j.placenta.2007.11.001

Le, T. M., Nguyen, L. H., Nguyen, H. P., & Truong, Q. D. (2019). Maternal serum uric acid concentration and pregnancy outcomes in women with pre-eclampsia/eclampsia. International Journal of Gynecology & Obstetrics, 144(1), 21–26. https://doi.org/10.1002/ijgo.12697

Many, A., Hubel, C. A., Fisher, S. J., Roberts, J. M., & Zhou, Y. (2000). Invasive cytotrophoblasts manifest evidence of oxidative stress in preeclampsia. American Journal of Pathology, 156(1), 321–331. https://doi.org/10.1016/S0002-9440(10)64733-5

Mehta, M., Shah, S., & Patel, P. (2019). A comparative study of serum uric acid, urea, and creatinine levels in normal pregnancy and pregnancy-induced hypertension. International Journal of Clinical Biochemistry and Research, 6(1), 90–94. https://doi.org/10.18231/2394-6377.2019.0022

Redman, C. W., & Sargent, I. L. (2005). Latest advances in understanding preeclampsia. Science, 308(5728), 1592–1594. https://doi.org/10.1126/science.1111726

Ugwuanyi, R. U., Chiebi, A. U., Lawrence, I. A., & Aguegboh, N. W. (2021). Association between serum uric acid levels and perinatal outcome in women with preeclampsia. Obstetrics and Gynecology International, 2021, 1–8. https://doi.org/10.1155/2021/6612042

Zangana, J. M., & Hamadamen, A. I. (2019). Serum uric acid as a predictor of perinatal outcome in women with pre-eclampsia. Zanco Journal of Medical Sciences, 23(1), 114–121. https://doi.org/10.15218/zjms.2019.015

Roberts, J. M., Bodnar, L. M., Lain, K. Y., Hubel, C. A., Markovic, N., Ness, R. B., & Powers, R. W. (2005). Uric acid is as important as proteinuria in identifying fetal risk in women with gestational hypertension. Hypertension, 46(6), 1263–1269. https://doi.org/10.1161/01.HYP.0000188703.27002.14

AJMHC, E-Palli Publishers

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Published

2026-06-16

Issue

Vol. 1 No. 1 (2026): American Journal of Medicine and Health Care

Section

Research Articles

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Copyright (c) 2026 Aqsa Akram (Author)

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This work is licensed under a Creative Commons Attribution 4.0 International License.

How to Cite

Akram, A. . (2026). The Predictive Role of Serum Uric Acid in Adverse Perinatal Outcomes Among Pre-eclamptic Women: A Prospective Cohort Study. American Journal of Medicine and Health Care, 1(1), 96-99. https://doi.org/10.54536/ajmhc.v1i1.6627

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