Comparison Of The Maternal Uric Acid Levels With Gestational Age In Normotensive Pregnancies

Abstract

Aim: Maternal serum uric acid levels are increased in the last trimester of pregnancy. Maternal hyperuricemia has been associated with preeclampsia, gestational diabetes. Also the association of hyperurisemia with low birth weighted fetus for gestational age was shown . In this study, we aimed to investigate the relationship between gestational age and maternal blood uric acid levels.Material and Methods: The study was conducted in the gynecology and obstetrics clinic of an university hospital and normotensive pregnant women with singleton fetus were included in the study . Gestational hypertension , preeclampsia, gestational and pregestational diabetes mellitus were excluded from the study . Maternal serum uric acid levels were evaluated in the third trimester.Results: The study was included 360 pregnant women. The mean age, gravida and parity were 29.8 ± 0.3, 2.1 ± 0.6, 1.2 ± 0.5, respectively. The mean gestational age was 39.2 ± 0.2, systolic blood pressure SBP was 112.2 ± 0.7mmHg and diastolic blood pressure DBP was 71.6 ± 0.6 mmHg . the mean neonatal birth weight was 3332 ± 30 gram. Mean uric acid value was 4.45 ± 0.06. There was no statistically significant relationship between gestational age at bith and maternal blood uric acid values p> 0.05 . In addition, no statistically significant correlation was determined between fetal weight, gestational age and blood uric acid levels r = 0.054 , p = 0.344 and r = 0.006, p = 0.913 .Conclusion: Increased uric acid values are known to cause maternal oxidative stress and vascular abnormalities in the placenta, and leading to the development of preeclampsia and adverse maternal and fetal outcomes. However, no significant correlation have been found between the advancement of gestational age and maternal serum uric acid levels.

Keywords

• Uric acid,pregnancy,gestational age

Normotansif Gebelerde Maternal Kan Ürik Asit Değerlerinin Gestasyonel Yaş İle Karşılaştırılması

Abstract

Amaç: Maternal ürik asit düzeyleri gebeliğin son trimesterinde artış göstermektedir. Maternal hiperürisemi; preeklampsi, gestasyonel diyabet ve gestasyonel yaşa göre düşük doğum ağırlıklı bebeklerle ilişkili bulunmuştur. Bu çalışmada doğum haftası ile maternal hiperürisemi arasında ilişki olup olmadığı araştırılmıştır.Gereç ve Yöntemler: Bir üniversite hastanesi kadın hastalıkları ve doğum kliniğinde doğum yapan tekil, canlı fetüse sahip, normotansif gebeler çalışma kapsamına alınmıştır. Gestasyonel hipertansiyon, preeklampsi, gestasyonel ve pregestasyonel diabetes mellitusu olan olgular çalışma dışı bırakılmıştır. Doğum sırasındaki maternal kanda ürik asit düzeyleri değerlendirilmiştir.Bulgular: Çalışmaya 360 gebe kadın dahil edilmiştir. Olguların ortalama yaş, gravide ve pariteleri sırasıyla 29.8±0.3, 2.1±0.6, 1.2±0.5 olarak belirlenmiştir. Ortalama gestasyonel yaş 39.2±0.2, sistolik kan basıncı SKB değeri 112.2±0.7 mmHg diastolik kan basıncı DKB değeri 71.6±0.6 mmHg’dir. Yenidoğanların doğum ağrılıkları 3332±30 gr’dır. Ortalama ürik asit değerleri 4.45±0.06’dir. Doğum haftası ile maternal kan ürik asit değerleri arasında istatistiksel olarak anlamlı bir ilişki tespit edilememiştir p>0.05 . Ayrıca fetal ağırlık ve gestasyonel yaş ile kan ürik asit değerleri arasında korelasyon saptanamamıştır r=0.054, p=0.344 ve r= 0.006, p=0.913 .Sonuç: Artmış maternal ürik ait değerleri plasentada oksidatif stres ve vaskuler anormalliklere yol açarak preeklampsi gelişimine ve olumsuz maternal ve fetal sonuçlara yol açtığı bilinmektedir. Ancak gestasyonel yaşın ilerlemesi ile maternal ürik asit düzeylerinin artışı arasında anlamlı bir ilişki bulunamamıştır.

Keywords

• Ürik asit,gebelik,gestasyonel yaş

References

1. Kanellis J, Watanabe S, Li JH ve ark. Uric acid stimulates monocyte che- moattractant protein-1 production in vascular smooth muscle cells via mitogen-activated protein kinase and cyclooxygenase-2. Hypertension. 2003;41:1287–93.
2. Carter J, Child A. Serum uric acid levels in normal pregnancy. Aust N Z J Obstet Gynaecol. 1989;29:313–4.
3. Lind T, Godfrey KA, Otun H ve ark. Changes in serum uric acid concentra- tions during normal pregnancy. Br J Obstet Gynaecol 1984;91:128–132.
4. Patschan D, Patschan S, Gobe GG ve ark. Uric acid heralds ischemic tissue injury to mobilize endothelial progenitor cells. J Am Soc Nephrol. 2007;18:1516–24.
5. Bainbridge SA, von Versen-Höyncka F, Robertsa JM. Uric Acid Inhibits Placental System A Amino Acid Uptake Placenta. 2009;30:195–200.
6. Bainbridge SA, Roberts JM. Uric acid as a pathogenic factor in preeclam- psia. Placenta 2008;29 Suppl A:S67–72.
7. Laughon SK, Catov J, Provins T ve ark. Elevated first-trimester uric aci- dconcentrations are associated with the development of gestational dia- betes. Am J Obstet Gynecol 2009;201:402–5.
8. Bellomo G, Venanzi S, Saronio P ve ark. Prognostic significance of se- rum uric acid in women with gestational hypertension. Hypertension 2011;58:704–708.

9. Roberts JM, Bodnar LM, Lain KY ve ark. Uric acid is as important as pro- teinuria in identifying fetal risk in women withgestational hypertension. Hypertension 2005; 46:1263–1269.
10. Wu Y, Xiong X, Fraser WD ve ark. Association of uric acid with progressi- on to preeclampsia and development of adverse conditions in gestational hypertensive pregnancies. Am J Hypertension 2012; 25:711-717.
11. Akahori Y, Masuyama H, Hiramatsu Y. The correlation of maternal uric acid concentration with small-for-gestational-age fetuses in normotensi- ve pregnant women. Gynecol Obstet Invest 2012;73:162–167.
12. Kang DH, Finch J, Nakagawa T ve ark.. Uric acid, endothelial dysfunc- tion and pre-eclampsia: searching for a pathogenetic link. J Hypertens 2004;22:229-235.
13. Dane B, Kayaoğlu Z, Dane C ve ark. İkinci trimester yüksek maternal ürik asit değerlerinin uterin arterlerde bilateral erken diyastolik çentiklenme mevcudiyeti ve gebelik komplikasyonları ile ilişkisi. Perinatoloji Dergisi 2011;19:64-70.
14. Mahendran D, Donnai P, Glazier JD ve ark. Amino acid (system A) transporter activity in microvillous membrane vesicles from the pla- centas of appropriate and small for gestational age babies. Pediatr Res 1993;34:661-665.
15. Powers RW, Bodnar LM, Ness RB ve ark. Uric acid concentrations in early pregnancy among preeclamptic women with gestational hyperuri- cemia at delivery. Am J Obstet Gynecol 2006;194:160.
16. Baumann MU, Deborde S, Illsley NP. Placental glucose transfer and fetal growth. Endocrine 2002;19:13-22.
17. Mahendran D, Byrne S, Donnai P ve ark. Na+ transport, H+ concent- ration gradient dissipation, and system A amino acid transporter activity in purified microvillous plasma membrane isolated from first-trimester human placenta: comparison with the term microvillous membrane. Am J Obstet Gynecol 1994;171:1534-1540.
18. Smith R, Maiti K, Aitken RJ. Unexplained antepartum stillbirth: A con- sequence of placental aging? Placenta 2013;34:310-313.