Am J Perinatol 2002; 19(6): 291-296
DOI: 10.1055/s-2002-34470
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Effect of Fetal Number on Maternal Serum Uric Acid Concentration

Shlomo B. Cohen, Doron Kreiser, Izhar Erez, Inna Kogan, Daniel S. Seidman, Eyal Schiff
  • J. Buchman Maternity Center, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer; affiliated to the Sackler School of Medicine and Tel-Aviv University, Israel
Further Information

Publication History

Publication Date:
01 October 2002 (online)

ABSTRACT

The aim of this study was to examine whether maternal serum uric acid (UA) concentrations are influenced by the number of fetuses and whether this effect is confounded by maternal body mass index (BMI). Medical records of 207 consecutive twin and 69 triplet pregnancies admitted to our high-risk pregnancy unit between 1994 and 1998 were reviewed. Pregnancies complicated by acute or chronic renal diseases, vascular diseases, hypertension, hemolysis, diabetes mellitus, or proteinuria were excluded. The remaining 137 twin and 42 triplet pregnancies were matched with 118 consecutive singleton pregnancies who met the same exclusion criteria and were admitted in the first half of 1998. Each birth order study group was further stratified and compared within three maternal BMI subgroups. Serum UA concentrations were higher in twin and triplet pregnancies compared to singletons (4.6 ± 1.3, 5.2 ± 1.2, and 3.8 ± 0.7 mg%, respectively; p <0.01). These differences in UA concentration persisted after grouping by BMI classes. Serum UA concentration in pregnancy are positively correlated with the number of fetuses. For clinical purpose, the UA cutoff concentration should be adjusted using mean + 2 SD as follows: 5.2, 7.2, and 7.6 for singleton, twin, and triplets, respectively.

REFERENCES

  • 1 Slemmons J M. The uric acid content of maternal and fetal blood.  J Biol Chem . 1917;  32 63-69
  • 2 Lim K H, Friedman S A, Ecker J L, Kao L, Kilpatrick S J. The clinical utility of serum uric acid measurements in hypertensive diseases of pregnancy.  Am J Obstet Gynecol . 1998;  178 1067-1071
  • 3 Martin Jr N J, May W L, Magann E F, Terrone D A, Rinehart B K, Blake P G. Early risk assessment of severe preeclampsia: admission battery of symptoms and laboratory tests to predict likelihood of subsequent significant maternal morbidity.  Am J Obstet Gynecol . 1999;  180 1407-1414
  • 4 Hill L M. Metabolism of uric acid in normal and toxemic pregnancy.  Mayo Clin Proc . 1978;  53 743-751
  • 5 Yoshimura A, Ideura T, Iwasaki S, Koshikawa S. Significance of uric acid clearance in preeclampsia [letter].  Am J Obstet Gynecol . 1990;  162 1639-1640
  • 6 Fadel H E, Northrop G, Misenhimer H R. Hyperuricemia in pre-eclampsia: a reappraisal.  Am J Obstet Gynecol . 1976;  125 640-647
  • 7 Gallery E D, Gyory A Z. Glomerular and proximal renal tubular function in pregnancy-associated hypertension: a prospective study.  Eur J Obstet Gynecol Reprod Biol . 1979;  9 3-12
  • 8 Many A, Hubel C A, Roberts J M. Hyperuricemia and xanthine oxidase in preeclampsia, revisited.  Am J Obstet Gynecol . 1996;  174 288-291
  • 9 Lind T, Godfrey K A, Otun H, Philips P R. Changes in serum uric acid concentrations during normal pregnancy.  Br J Obstet Gynaecol . 1984;  91 128-132
  • 10 Carter J, Child A. Serum uric acid concentration in normal pregnancy.  Aust N Z J Obstet Gynaecol . 1989;  29 313-314
  • 11 Chang F T, Chang S J, Wu Y Y, Wang T N, Ko Y C. Body mass index and hyperuricemia differences between aboriginal and non-aboriginal children in Taiwan.  Kao Hsiung I Hsueh Ko Hsueh Tsa Chih . 1995;  11 315-321
  • 12 Takahashi S, Yamamoto T, Tsutsumi Z, Moriwaki Y, Yamakita J, Higashino K. Close correlation between visceral fat accumulation and uric acid metabolism in healthy men.  Metabolism . 1997;  46 1162-1165
  • 13 Suzuki S, Yoneyama Y, Sawa R, Araki T. Relation between serum uric acid and plasma adenosine concentration in twin pregnancies.  Obstet Gynecol . 2000;  96 507-510
  • 14 Fischer R L, Weisberg L S, Hediger M L. Etiology of third-trimester maternal hyperuricemia in nonpreeclamptic twin gestations.  Obstet Gynecol . 2001;  97 62-65
  • 15 Fischer R L, Bianculli K W, Hediger M L, Scholl T O. Maternal serum uric acid concentration in twin gestations.  Obstet Gynecol . 1995;  85 60-64
  • 16 Hsu C D, Chung Y K, Lee I S, Chou K, Copel J A. Maternal serum uric acid concentration in preeclamptic women with multiple gestations [see comments].  Am J Perinatol . 1997;  14 613-617
  • 17 Many A, Westerhausen-Larson A, Kanbour-Shakir A, Roberts J M. Xanthine oxidase/dehydrogenase is present in human placenta.  Placenta . 1996;  17 361-365
  • 18 Serr D, Czaczkes J, Zukerman H. Comperative studies on uric-acid concentration in amniotic fluid, fetal blood, and maternal blood.  Obstet Gynecol . 1963;  21 551-553
  • 19 Koike T, Minakami H, Takayama T, Ogawa S, Kuwata T, Sato I. Elevation of the serum uric acid level preceding the clinical manifestation of preeclampsia in twin pregnancies.  Gynecol Obstet Invest . 1997;  44 97-101