The Correlation between High Uric Acid Levels and the Severity of Preeclampsia

Exploring the Link Between Hyperuricemia and Preeclampsia Severity: A Clinical Perspective

Authors

  • I Wayan Artana Putra Fetomaternal Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Udayana University, Prof. Dr. I.G.N.G Ngoerah General Hospital, Denpasar, Indonesia
  • Endang Sri Widiyanti Fetomaternal Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Udayana University, Prof. Dr. I.G.N.G Ngoerah General Hospital, Denpasar, Indonesia
  • Amanda Sherman Department of Obstetrics and Gynecology, Faculty of Medicine, Udayana University, Prof. Dr. I.G.N.G Ngoerah General Hospital, Denpasar, Indonesia

DOI:

https://doi.org/10.25077/aoj.10.1.16-25.2026

Keywords:

Pregnancy, preeclampsia, severity, uric acid

Abstract

Introduction: Preeclampsia is a pregnancy complication marked by hypertension and multi-organ dysfunction, contributing to significant maternal and fetal morbidity and mortality, particularly in developing nations. Identifying severe cases early remains challenging due to limited biomarker specificity and predictive accuracy. Uric acid has been proposed as a potential marker, though its reliability in predicting severity remains debated.

Methods: This cross-sectional study included 54 pregnant women diagnosed with preeclampsia at RSUP Prof. Dr. I.G.N.G Ngoerah, Denpasar, with a gestational age of over 20 weeks. Participants were selected through consecutive sampling. Data on serum uric acid, blood pressure, proteinuria, and creatinine levels were analyzed using parametric statistical tests to assess correlations with preeclampsia severity.

Results: Elevated uric acid levels (>6 mg/dL) were significantly associated with severe preeclampsia (p=0.039), with a prevalence ratio of 2.96. Strong correlations were found between uric acid and blood pressure (r=0.71, p=0.012) and proteinuria (r=0.64, p=0.012), while a moderate correlation existed with serum creatinine (r=0.40, p=0.002).

Conclusion: Serum uric acid levels can be a useful indicator for assessing preeclampsia severity. However, its predictive value should be combined with other clinical and biochemical markers to enhance early detection and management strategies

References

1. American College of Obstetricians and Gynecologists. Hypertension in pregnancy. Obstet Gynecol. 2020;135(2):e126–50.

2. Roberts JM, Hubel CA. The two-stage model of preeclampsia: variations on the theme. Placenta. 2009;30 Suppl A:S32–7.

3. Ananth CV, Keyes KM, Wapner RJ. Pre-eclampsia rates in the United States, 1980–2010: age-period-cohort analysis. BMJ. 2013;347:f6564.

4. Rana S, Lemoine E, Granger JP, Karumanchi SA. Preeclampsia: pathophysiology, challenges, and perspectives. Circ Res. 2019;124(7):1094–112.

5. Bartsch E, Medcalf KE, Park AL, Ray JG. Clinical risk factors for pre-eclampsia determined in early pregnancy: systematic review and meta-analysis of large cohort studies. BMJ. 2016;353:i1753.

6. Bainbridge SA, Roberts JM. Uric acid as a pathogenic factor in preeclampsia. Placenta. 2008;29 Suppl A:S67-72.

7. Khaliq OP, Konoshita T, Moodley J, Naicker T. The role of uric acid in preeclampsia: is it a biomarker? Obstet Med. 2018;11(2):66-73.

8. Pecoraro A, Trenti T. Uric acid as a predictor of preeclampsia: an updated systematic review and meta-analysis. Pregnancy Hypertens. 2020;20:50-5.

9. Roberts JM, Bodnar LM, Lain KY, Hubel CA. Uric acid as a pathogenetic factor in preeclampsia. Placenta. 2005;26(7):S67-S72.

10. Kang DH, Nakagawa T. Uric acid and chronic renal disease: possible implication of hyperuricemia on progression of renal disease. Semin Nephrol. 2005;25(1):43-9.

11. Sánchez-Lozada LG, Tapia E, Avila-Casado C, Soto V, Franco M, Santamaría J, et al. Mild hyperuricemia induces glomerular hypertension in normal rats. Am J Physiol Renal Physiol. 2002;283(5):F1105-10.

12. Khosla UM, Zharikov S, Finch JL, Nakagawa T, Roncal C, Mu W, et al. Hyperuricemia induces endothelial dysfunction. Kidney Int. 2005;67(5):1739-42.

13. Jim B, Karumanchi SA. Preeclampsia: pathogenesis, prevention, and long-term complications. Semin Nephrol. 2017;37(4):386-97.

14. Mulla MJ, Myrtolli K, Brosens JJ, Chamley LW, Giles I, Pericleous C, et al. Antiphospholipid antibodies induce placental inflammation and defective trophoblast invasion through direct and indirect pathways. Am J Reprod Immunol. 2013;69(2):150-8.

15. Sánchez-Aranguren LC, Prada CE, Riaño-Medina CE, Lopez M. Endothelial dysfunction and preeclampsia: role of oxidative stress. Front Physiol. 2014;5:372.

16. Thangaratinam S, Ismail KM, Sharp S, Coomarasamy A, Khan KS. Tests for predicting pre-eclampsia: a systematic review. BJOG. 2006;113(6):612-25.

17. Jeyabalan A, Conrad KP. Renal function during normal pregnancy and preeclampsia. Front Biosci. 2007;12:2425-37.

18. van der Graaf AM, van der Tuuk K, Franx A, Bloemenkamp KW, Duvekot JJ, van Pampus MG, et al. Use of uric acid for prediction of maternal complications in pre-eclampsia: a systematic review. Hypertens Pregnancy. 2015;34(4):464-83.

19. Roberts JM, August PA, Bakris G, Barton JR, Bernstein IM, Druzin M, et al. Hypertension in pregnancy. Obstet Gynecol. 2013;122(5):1122-31.

20. Brown MA, Magee LA, Kenny LC, Karumanchi SA, McCarthy FP, Saito S, et al. Hypertensive disorders of pregnancy: ISSHP classification, diagnosis, and management recommendations for international practice. Hypertension. 2018;72(1):24-43.

21. Bellos I, Pergialiotis V, Loutradis D, Daskalakis G. The prognostic role of uric acid in preeclampsia: a meta-analysis. J Clin Hypertens. 2020;22(5):826-34.

22. Powers RW, Bodnar LM, Ness RB, Cooper KM, Gallaher MJ, Frank MP, et al. Uric acid concentrations in early pregnancy among preeclamptic women. Am J Obstet Gynecol. 2006;194(1):160–5.

23. Kang DH, Finch J, Nakagawa T, Karumanchi SA, Kanellis J, Granger J, et al. Uric acid, endothelial dysfunction, and preeclampsia: searching for a pathogenetic link. J Clin Hypertens. 2004;6(10):661-8.

24. Bainbridge SA, Roberts JM. Uric acid as a pathogenic factor in preeclampsia. Placenta. 2008;29 Suppl A:S67-72.

25. Jiménez JM, Gupta A, Tang WY, Yao X, McKinney ET, Sharma S. Uric acid as a biomarker for predicting preeclampsia severity: systematic review and meta-analysis. Hypertens Pregnancy. 2021;40(1):11-20.

Downloads

Published

2026-02-02

How to Cite

Putra, I. W. A., Widiyanti, E. S., & Amanda Sherman. (2026). The Correlation between High Uric Acid Levels and the Severity of Preeclampsia: Exploring the Link Between Hyperuricemia and Preeclampsia Severity: A Clinical Perspective. Andalas Obstetrics And Gynecology Journal, 10(1), 16–25. https://doi.org/10.25077/aoj.10.1.16-25.2026

Issue

Section

RESEARCH ARTICLE