High Maternal Serum Uric Acid Levels and Risk of Low-Birth-Weight and Small for Gestational Age Infant: A Systematic Review and Meta-Analysis.

Abstract

Although the association between high uric acid levels and adverse pregnancy outcomes has been explored, the effects of elevated uric acid levels on the risk of low-birth-weight (LBW) and small for gestational age (SGA) remain unclear. Therefore, this systematic review and meta-analysis aimed to investigate the relationship between uric acid levels during pregnancy and the risk of LBW. PubMed, Scopus, Cochrane central and Web of Science databases were searched up to September 2024 for relevant observational studies. A random effects model was used to estimate pooled odds ratios (OR) and 95% confidence intervals (95% CI). To assess the heterogeneity of included studies, the I² index was used. Finally, 29 observational studies were eligible for inclusion in this meta-analysis. Pooled analysis showed that higher uric acid levels significantly increased the risk of LBW (OR = 2.28, 95% CI: 1.62-3.22, P < 0.001; I² = 93.14%, n = 21 studies) and SGA (OR = 1.77, 95% CI 1.38-2.27, P < 0.001, I² = 91.67%, n = 14 studies). However, there was no significant effect of high uric acid levels and macrosomia (OR = 1.29, 95% CI 0.52-3.18, P = 0.59, I² = 71.86%, n = 3 studies). This study demonstrated a positive association between uric acid levels and the risk of LBW and SGA. It appears that elevated uric acid can significantly impact neonatal health, highlighting the critical importance of uric acid monitoring during pregnancy.