Maternal and Neonatal Health Risks Elevated in Pregnancies with Gout: Study Reveals

The findings, published in the International Journal of Gynecology & Obstetrics, highlight the importance of close monitoring and early intervention for expectant mothers with gout to minimize risks.

Gout, a form of inflammatory arthritis caused by elevated uric acid levels, can complicate pregnancy and lead to a variety of health concerns. The outcomes of pregnancy, delivery, and neonatal health in pregnancies affected by gout have not yet been assessed in a population-based study. Therefore, Sam Amar, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada, and colleagues aimed to assess obstetric and neonatal outcomes in pregnant individuals with gout using a national population database.

For this purpose, the researchers conducted a retrospective population-based cohort study using data from the Healthcare Cost and Utilization Project, Nationwide Inpatient Sample (HCUP-NIS). The study included all women in the USA who either delivered or experienced a maternal death between 2004 and 2014. Pregnancy, delivery, and neonatal outcomes were compared between women with an ICD-9 diagnosis of gout and those without.

The study led to the following findings:

• A total of 9,096,788 women met the study's inclusion criteria.
• Of these, 168 women (1.8 per 100,000) had a diagnosis of gout.
• Women with gout were more likely to be older, obese, and have chronic hypertension, pregestational diabetes mellitus, and thyroid disease compared to those without gout.
• Pregnant women with gout had a higher likelihood of developing gestational diabetes mellitus (adjusted odds ratio [aOR] 1.78).
• These women were more likely to require operative vaginal delivery (aOR 3.26) than those without gout.
• Women with gout had an increased risk of venous thromboembolism (aOR 8.47) compared to non-gout counterparts.
• Gout was associated with a higher likelihood of delivering neonates with congenital anomalies (aOR 3.38).

"To our knowledge, this is the largest study to date on the effects of gout on pregnancy outcomes. However, its retrospective design limited direct data collection and excluded certain maternal factors like thrombophilia, autoimmune disease, and congenital heart disease. Additionally, uric acid levels and the timing of gout attacks during pregnancy were not assessed," the researchers wrote.

"The findings suggest that gout during pregnancy is associated with adverse maternal outcomes, including gestational diabetes, pulmonary embolism, and an increased likelihood of operative vaginal delivery," the researchers concluded. "It is also linked to a higher risk of congenital anomalies in neonates." They emphasized that pregnant individuals with a history of gout or those experiencing gout flares should receive appropriate counseling and targeted diagnostic screening.

Reference:

Amar, S., Badeghiesh, A., Baghlaf, H., & Dahan, M. H. Gout in pregnancy: Obstetric and neonatal outcomes. International Journal of Gynecology & Obstetrics. https://doi.org/10.1002/ijgo.16025