Maternal serum uric acid before 24 weeks of gestation and subsequent gestational diabetes mellitus: a multicentre retrospective cohort study.

INTRODUCTION

This multicentre retrospective cohort study examined whether maternal serum uric acid measured before 24 weeks of gestation was associated with subsequent gestational diabetes mellitus (GDM), with hypertensive disorders of pregnancy (HDP) assessed as a related cardiometabolic outcome.

METHODS

We included 5,614 pregnancies from three hospitals in China. For each pregnancy, the earliest eligible uric acid measurement before 24 weeks of gestation was retained. Uric acid was analysed in quartiles and per 10 μmol/L increase. Modified Poisson regression with robust variance estimated relative risks (RRs), restricted cubic splines assessed dose-response patterns, and sensitivity analyses examined the stability of the findings.

RESULTS

GDM occurred in 1,187 pregnancies (21.1%) and HDP in 275 pregnancies (4.9%). Compared with Q1, Q4 was associated with higher risk of GDM (adjusted RR, 1.54; 95% CI, 1.34 to 1.77) and HDP (adjusted RR, 1.89; 95% CI, 1.33 to 2.67). Each 10 μmol/L increase in uric acid was associated with GDM (adjusted RR, 1.03; 95% CI, 1.02 to 1.04) and HDP (adjusted RR, 1.04; 95% CI, 1.02 to 1.06). Spline analyses showed modest evidence of nonlinearity for GDM but not for HDP.

DISCUSSION: Maternal serum uric acid measured before 24 weeks of gestation was associated with subsequent GDM, with a related association observed for HDP. Uric acid may complement established maternal risk factors but should not be interpreted as a standalone screening test.