Prognostic Value of Serum Uric Acid in Preeclampsia

Role in Clinical Assessment

Serum uric acid is explicitly not a diagnostic criterion for preeclampsia, but serves as a prognostic marker when elevated, particularly in women with chronic hypertension or suspected preeclampsia, as recommended by the International Society for the Study of Hypertension in Pregnancy (ISSHP) 1, 2
The ISSHP recommends measuring uric acid as part of baseline testing in all women with chronic hypertension or suspected preeclampsia to establish a reference point for monitoring disease progression, with elevated gestation-corrected uric acid levels prompting detailed assessment of fetal growth 1, 2
Elevated gestation-corrected uric acid levels should prompt detailed assessment of fetal growth, even in women with gestational hypertension alone, as part of a comprehensive preeclampsia assessment 1, 3

Uric acid should never be used alone to determine the timing of delivery, and should be interpreted alongside other markers including blood pressure, proteinuria, platelet count, liver enzymes, and creatinine as part of comprehensive preeclampsia assessment 1, 2

The American College of Cardiology and European Society of Cardiology include uric acid measurement as part of the diagnostic workup for preeclampsia, recognizing its clinical significance 4, 5
The International Society of Hypertension recommends measuring serum uric acid as part of the investigation of hypertension in pregnancy 4
The European Society of Cardiology includes uric acid in the diagnostic workup for preeclampsia 6

Higher uric acid levels correlate with severe preeclampsia, hepatic dysfunction, and preterm delivery, though the American College of Obstetricians and Gynecologists advises against using uric acid level alone as an indication for delivery 7
Do not use uric acid level alone to determine disease severity or timing of delivery, as serious organ dysfunction can develop at various uric acid levels 7
Uric acid should be interpreted alongside other markers including blood pressure, proteinuria, platelet count, liver enzymes, and creatinine as part of comprehensive preeclampsia assessment 4, 5