Accuracy of serum uric acid determination in predicting pre-eclampsia: A systematic review

JS Cnossen, H De Ruyter-Hanhijarvi, JAM van der Post, BWJ Mol, Khalid Khan, Gerben ter Riet

Research output: Contribution to journalReview article

46 Citations (Scopus)


Background. Pre-eclampsia is a leading cause of maternal and perinatal mortality and morbidity. Early prediction of preeclampsia may be used to target high-risk women for effective preventative treatments. Hyperuricemia is associated with pre-eclampsia and it has been tested in early pregnancy for its ability to predict the later onset of the disease. Objective. To systematically review the accuracy of determining serum uric acid before the 25th gestational week in predicting preeclampsia. Methods. We searched Medline, Embase, Cochrane Library, Medion, bibliographies of review articles and eligible primary studies, and contacted experts in the field. Language restrictions were not applied. Reviewers working independently selected studies, extracted data and assessed validity according to eight criteria. Sensitivities and specificities were plotted in a Receiver Operating Characteristic plot. Results. We identified five primary articles, with a total of 572 women, including 44 who developed pre-eclampsia. Study populations differed clinically, with incidences ranging from 3.4% to 40.1%. Sensitivity ranged from 0.0% to 55.6% and specificity ranged from 76.9% to 94.9%. Clinical heterogeneity and poor reporting precluded sensible pooling of data. In particular, consecutive entry of eligible women, blind assessment of the reference standard, and treatment to prevent pre-eclampsia were poorly reported. Conclusion. Contrary to previous reviews, we conclude that there is currently insufficient evidence to draw firm conclusions about the accuracy of serum uric acid determination in predicting pre-eclampsia.
Original languageEnglish
Pages (from-to)519-525
Number of pages7
JournalActa obstetricia et gynecologica Scandinavica
Issue number5
Publication statusPublished - 1 Jan 2006


  • pre-eclampsia
  • uric acid
  • prediction
  • accuracy
  • systematic review


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