MATERNAL SERUM URIC ACID AS A PREDICTOR OF DISEASE SEVERITY AND PERINATAL OUTCOME IN WOMEN WITH ECLAMPSIA

Abstract

Background: Preeclampsia and eclampsia are major causes of maternal and perinatal morbidity and mortality. Maternal serum uric acid has been proposed as a simple biochemical marker for assessing disease severity and predicting adverse pregnancy outcomes. Objective: To evaluate maternal serum uric acid as a predictor of disease severity and perinatal outcome in women with preeclampsia and eclampsia. Methods: This prospective observational study was conducted at the Department of Obstetrics & Gynecology, Arif Memorial Teaching Hospital/ Rashid Latif Medical College Lahore from December 2024 to June 2025 included 120 pregnant women with preeclampsia or eclampsia. Maternal serum uric acid, blood pressure, renal and hematological parameters, maternal complications, and perinatal outcomes were recorded. Serum uric acid levels were compared according to disease severity and adverse outcomes. Results: Mean serum uric acid increased significantly from 5.1±1.0 mg/dL in non-severe preeclampsia to 6.8±1.2 mg/dL in severe preeclampsia and 7.6±1.4 mg/dL in eclampsia (p<0.001). Women with uric acid ≥6.2 mg/dL had higher rates of severe preeclampsia/eclampsia (86.8% vs. 40.4%), HELLP syndrome (20.6% vs. 5.8%), ICU admission (23.5% vs. 7.7%), preterm delivery (61.8% vs. 34.6%), low birth weight (57.4% vs. 30.8%), NICU admission (48.5% vs. 23.1%), and perinatal mortality (17.6% vs. 3.8%). A cutoff of 6.2 mg/dL predicted severe preeclampsia/eclampsia with an AUC of 0.82, sensitivity of 78.8%, specificity of 73.1%, and adjusted OR of 4.62. Conclusion: Higher maternal serum uric acid levels were associated with increasing disease severity and adverse maternal and perinatal outcomes. Serum uric acid may serve as a simple and inexpensive adjunct for risk stratification in women with preeclampsia and eclampsia.