52: Uric acid levels in the highest quartile of the normal range during pregnancy are associated with an increased risk for long-term maternal atherosclerotic morbidity


      To examine the association between uric acid (UA) level during pregnancy and the development of future long-term maternal atherosclerotic morbidity (including cardiovascular, cerebrovascular and renal disease).

      Study Design

      A case-control study was conducted including women who delivered between the years 2000-2012 and subsequently develop atherosclerotic morbidity (n=588); controls were matched for age and year of delivery (n=3645). The mean follow-up duration was 74 months. The hospitalized group was further divided to major event (cardiovascular, cerebrovascular disease, chronic renal failure), and cardiac procedures (such as coronary angiography). Kaplan-Meier survival curves were used to estimate cumulative incidence of cardiovascular, cerbrovascular and renal hospitalizations. Cox proportional hazards models were used to estimate the adjusted hazard ratios (HR) for hospitalizations.


      A significant linear association was documented between UA during pregnancy and long-term maternal atherosclerotic morbidity (Table). Using a Kaplan-Meier survival curve, UA levels in the high quartiles of the normal range had a significantly higher cumulative incidence of hospitalizations (P<0.001; Figure). A Cox proportional hazard model, adjusted for confounders such as preeclampsia, diabetes mellitus, and obesity, showed that high UA levels during pregnancy remained independently associated with atherosclerotic hospitalizations (adjusted HR=1.28; 95% CI 1.15-1.43; P<0.001).


      UA level at the high normal range during pregnancy may predict maternal atherosclerotic morbidity later in non-pregnant life.
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