Pregnant women with hypertension who also have elevated blood uric acid levels may face an increased risk of complications that could be fatal for mother and baby, University of Pittsburgh researchers have found.
Reporting in the Oct. 27 online issue of Hypertension, a journal published by the American Heart Association, researchers note that the greatest risk of high blood pressure during pregnancy accompanies preeclampsia, a devastating disorder that affects some 5 percent of first pregnancies and is traditionally diagnosed by increased blood pressure and the presence of protein in the urine. The only effective treatment is immediate delivery, which, if too early, can pose risks to the fetus.
In developed countries where prenatal care is routine, preeclampsia accounts for about 15 percent of premature deliveries a year. Worldwide, in settings without good prenatal care, preeclampsia increases the risk of fetal death five-fold and kills 50,000 women a year, researchers said. For clinicians, treating preeclampsia is a delicate balance of fetal and maternal risk from the disease and fetal development-associated risk because of premature delivery.
"We used a research database to ask whether inclusion of uric acid levels in the diagnosis of preeclampsia would help us to evaluate risk for complications among patients," said James M. Roberts, M.D., professor and vice chair of research in the department of obstetrics, gynecology and reproductive sciences at the University of Pittsburgh School of Medicine and the study's first author. "We focused primarily on fetal outcomes such as gestational age at delivery and birth weight, but also looked at markers of maternal disease, including severely elevated blood pressure during labor."
Records for 972 pregnant women who were recruited between 1997 and 2002 as part of an ongoing preeclampsia study at the Magee-Womens Hospital of the University of Pittsburgh Medical Center were reviewed and the women were divided into eight groups: