The Protect Role of Serum Uric Acid to Premature Rupture of Membranes in Gestational Diabetes: a Cross-sectional Study

Background: Uric acid has strong antioxidant activity whereas its oxidative damage is closely related to many diseases. We assessed the association between serum uric acid (SUA) levels and premature rupture of membranes (PROM) in pregnant women with Gestational diabetes (GDM) in china. Method: In this cross-sectional study, a total of 456 pregnant women were enrolled. Anthropometric parameters for pregnant women were collected within 12 weeks of gestation. Weight gain during pregnancy was obtained from patients’ record. GDM was diagnosed according to 75-g oral glucose tolerance tests at 24-28th week’s gestation, and SUA was determined simultaneously. PROM was identified as the natural rupture of fetal membranes before the first stage of labor. Logistic models were fitted to identify the presence of PROM using clinical characteristics with (Model 1) or without serum uric acid (Model 2). Results: : There exist differences in BMI, haemoglobin A1c, fasting blood glucose, 1-hour postprandial glucose, 2h PG, insulin levels, weight gain during pregnancy, the rate of macrosomia, PROM between women with and without GDM (all P<0.05). Furthermore, individuals with PROM had lower level of SUA than those without PROM in GDM women (P=0.030). The odds ratio of PROM decreases with the increase of SUA level. The area under the receiver operating characteristic curves for PROM based on Model 1 was larger than that in Model 2 (0.86 versus 0.71, p<0.05). Conclusion: Elevated relatively SUA levels at the 24-28th weeks of gestation were associated with a lower risk of PROM in women with GDM. SUA may be a protective factor for PROM in GDM patient. The optimal concentration of uric acid in different diseases and different populations needs to be further studied.