Elevated Maternal Uric Acid during mid gestation may Predict Hypertensive Disorders of Pregnancy: Study

A study was conducted to examine the association between maternal serum uric acid measured during gestational weeks 4–24 and the subsequent development of hypertensive disorders of pregnancy in a large Chinese cohort. This historical cohort study included 84,298 singleton pregnancies registered at Shanghai First Maternity and Infant Hospital between 2013 and 2022. Serum uric acid was measured before 24 weeks of gestation. Participants with pre-existing hypertension or incomplete data were excluded. Generalized additive models and multivariable logistic regression analyses were used to assess nonlinear and independent associations between uric acid levels (quartiles and continuous values) and the risks of gestational hypertension, preeclampsia, and overall hypertensive disorders of pregnancy, adjusting for maternal age, pre-pregnancy body mass index, education, and glucose metabolism disorders.

Results showed that uric acid levels were consistently higher among women who later developed hypertensive disorders of pregnancy than in normotensive pregnancies throughout gestational weeks 4–24. Higher uric acid concentrations were consistently associated with an increased risk of hypertensive disorders of pregnancy. The highest uric acid quartile showed the strongest associations with gestational hypertension (1.82, 1.59–2.08), preeclampsia (1.67, 1.48–1.89), and total hypertensive disorders of pregnancy (1.77, 1.61–1.94). Generalized additive model analyses revealed an enhanced relationship between uric acid and hypertensive disorders of pregnancy occurrence from the 4th week to the 24th week of gestation and showed specific patterns for gestational hypertension and preeclampsia, with the predictive strength of maternal uric acid increasing with advancing gestational age.

Elevated maternal uric acid levels in early to mid-gestation were independently related to the risk of hypertensive disorders of pregnancy, with subtype-specific and gestational-age-dependent patterns. Uric acid serves as a practical potential biomarker for early risk stratification and dynamic monitoring of women at risk for hypertensive complications during pregnancy. Elevated maternal uric acid (UA) levels during early to mid-gestation are independently associated with an increased risk of hypertensive disorders of pregnancy (HDP). This association varies by HDP subtype and gestational age. Maternal UA may serve as a practical biomarker for early risk stratification and for ongoing monitoring of women at risk for hypertensive complications during pregnancy.

Zou, C., Zhao, R., Liu, X., Yang, Y., Shen, Q., & Du, Q. (2025, December 12). Association of early and mid-pregnancy maternal serum uric acid with hypertensive disorders of pregnancy. Frontiers in Endocrinology, 16, Article 1731576. https://doi.org/10.3389/fendo.2025.1731576

Keywords:

Elevated, Maternal, Uric Acid, during, mid gestation, Predict, Hypertensive, Disorders, Pregnancy, study, Zou, C., Zhao, R., Liu, X., Yang, Y., Shen, Q., & Du, Q.