The frequency of hyperuricaemia & perinatal morbidity and mortality in Pakistani patients of pregnancy induced hypertension

Abstract

Objective: To determine the frequency of hyperuricaemia in patients with pregnancy induced hypertension and to compare the early neonatal outcome between patients with hyperuricaemia and those without hyperuricaemia among patients with pregnancy induced hypertension.

Material and Methods: This is a descriptive case series study which was conducted in the Department of Obstetrics and Gynecology, Benazir Bhutto Hospital Rawalpindi, Pakistan from March 2011 to August 2011. One hundred and fifty pregnant women with pregnancy induced hypertension (defined as a BP > 140/90 diagnosed at the gestational age > 20 weeks on two separate occasions) were included by non-probability consecutive sampling in the labour room and the out patient department. These patients had their uric acid levels measured by Beckman Coulter Cx 9, fully automated chemistry analyzer using Beckman’s uricase enzymatic, colorimetric, end point assay reagent. All patients underwent antenatal ultrasound with doppler studies in the last trimester to identify Intra Uterine Growth Retarded (IUGR) fetuses. These patients were followed till the time of delivery. The birth weight, NICU admissions and stillbirths/ intrauterine deaths were documented.

Results:  The mean age of the patients was 27.48±4.3 years and the mean gestational age was 35±2.85 weeks. The uric acid level of the patients ranged from 148 to 755μmol/L. The mean uric acid level of the patients was 372±106 μmol/L. Keeping the cutoff limit for hyperuricaemia as serum uric acid level > 325 μmol/L; we had 103 (68.7%) patients with hyperuricaemia. In the babies of these 103 patients, IUGR was seen in 99 (96.11%), IUD in 18 (17.48%), stillbirth in 2 (1.94%) and 72 (69.9%) were admitted to NICU. In the babies born to 47 patients who had no hyperuricaemia, IUGR was present in 32 (68.08%), 9 (19.14%) had IUD, 1 (2.12%) was stillbirth and 16 (34%) were admitted to NICU. Hence IUGR and admission to NICU were significantly more frequent among those with hyperuricaemia; p< 0.05. The mean birth weight of babies was 1.73±0.48 and 2.02±0.55 kg, respectively, among hyperuricaemic versus non-hyperuricaemic mothers; p= 0.002.

Conclusion: Hyperuricaemia is frequent among patients with pregnancy-induced hypertension. Babies of patients with hyperuricaemia had significantly more IUGR, admission to NICU and significantly low birth weight.

Keywords: Frequency, Uric acid, Hypertension, Serum, Stillbirth