Effect of Uric Acid Levels on Risk for Premature Rupture of Membranes in Gestational Diabetes

A pregnant woman having her glucose measured
Investigators assessed metabolic factors affecting the risk for premature rupture of membranes in pregnant women with gestational diabetes.

Women with gestational diabetes who have elevated levels of serum uric acid at 24 through 28 weeks of gestation were found to have a lower risk of premature rupture of membranes (PROM), suggesting serum uric acid may play a protective role against PROM in these women, according to study findings published in BMC Endocrine Disorders.

The cross-sectional study included 456 pregnant women who were recruited from a maternity clinic in a hospital in China. Researchers collected anthropometric parameters of the participants within 12 weeks of pregnancy. Data regarding weight gain were obtained from the women’s medical records, and prepregnancy weight was calculated using self-reported weight measurements.

A diagnosis of gestational diabetes was made based on findings from 75-g oral glucose tolerance tests taken at 24 to 28 weeks of pregnancy. A total of 152 women (mean age, 29 years) in the study had gestational diabetes; 304 women (mean age, 29 years) did not have gestational diabetes. Mean serum uric acid levels were 213 μmol/L in the group without gestational diabetes group and 230 μmol/L in the group with gestational diabetes (P =.130).

Significant differences were observed between patients with vs without gestational diabetes in terms of prepregnancy body mass index (BMI; 22.32 vs 21.23 kg/m2, respectively; P =.001), glycated hemoglobin (HbA1c; 4.90% vs 4.80%; P <.001), fasting plasma glucose (4.90 vs 4.20 mmol/L; P <.001), 1-hour postprandial glucose (9.80 vs 6.70 mmol/L; P <.001), 2-hour postprandial glucose (8.50 vs 6.30 mmol/L; P <.001), and infant birth weight (3542.10 ± 448.09 g vs 3398.92 ± 461.79 g; P =.003).

Women who experienced a natural rupture of membranes prior to the first stage of labor were classified as having a PROM event. A total of 130 women (mean age, 29 years) did not experience PROM, whereas 22 women (mean age, 32 years) had PROM. Women with PROM had significantly lower mean serum uric acid levels (197 vs 233 μmol/L; P =.03).

Serum uric acid levels were significantly associated with PROM in women with gestational diabetes in a multivariate analysis adjusted for age, prepregnancy BMI, 1-hour postprandial glucose, parity, and weight gain (P =.043). Additionally, maternal age was associated with PROM in patients with gestational diabetes (odds ratio [OR], 1.19; 95% CI, 1.01-1.42; P =.049).

In an analysis that stratified uric acid levels of the overall sample into 3 quantiles, PROM incidence decreased with increasing blood uric acid tertiles. The odds ratios for these tertiles were 0.13 (95% CI, 0.02-0.95) for the second tertile (198-247 μmol/L) and 0.07 (95% CI, 0.01-0.93) for the upper tertile (≥247 μmol/L) compared with the 1.0 for the lower tertile (0-197 μmol/L) (all P <.05).

Limitations of this study included its single-center design as well as the relatively short follow-up period.


Guo M, Lu J, Yu X, Hu X, Hou W, Pang S. The protective role of serum uric acid against premature membrane rupture in gestational diabetes: a cross-sectional study. BMC Endocr Disord. 2021;21(1):95. doi:10.1186/s12902-021-00736-3