Association of serum uric acid during pre-pregnancy with adverse pregnancy outcomes among women conceived by in-vitro fertilization
S M Chen, K X Lan, S H Yin, Z P Li, Y Wang, R Li, Y Y Zhao, Y WeiAbstract
Objectives
Maternal serum uric acid (UA) levels have been linked to adverse pregnancy outcomes, but no studies have yet examined this association in women undergoing assisted reproductive technology. This study aimed to investigate the relationship between pre-pregnancy UA levels and adverse pregnancy outcomes in women conceived via in vitro fertilization and embryo transfer (IVF-ET).
Methods
This retrospective cohort study included 2 111 singleton pregnancies conceived via IVF-ET, delivered at our University Hospital between 1 January 2017 and 30 April 2022. Restricted cubic splines were used to test nonlinear relationships between serum UA during pre-pregnancy and adverse outcomes, and multivariable logistic regression to calculate odds ratio (OR) and 95% confidence interval (CI).
Results
Of the 2 111 women, no significant associations were found between pre-pregnancy UA levels and preeclampsia, preterm birth, or macrosomia. However, a J-shaped relationship was observed for gestational diabetes mellitus (GDM) and low birth weight (LBW), and an inverse U-shaped relationship for gestational hypertension (GH). Women in higher quintile of UA had a 3.2-fold increased risk of GH (adjusted OR 3.20, 95% CI 1.23, 8.33) and a 1.38-fold increase in GDM (adjusted OR 1.38, 95% CI 1.01, 1.88). The highest UA quintile was associated with a 1.98-fold increased risk of LBW (adjusted OR 1.98, 95% CI 1.11, 3.54), with a stronger effect observed in day 5 embryo transfers (P-interaction=0.015).
Conclusions
These findings suggest that optimizing serum UA levels in women planning pregnancy, particularly those undergoing IVF-ET, may have important clinical implications for improving pregnancy outcomes.