妊娠期血尿酸水平异常与不良妊娠结局关系的研究进展

Research Progress on the Relationship between Abnormal Blood Uric Acid Levels and Adverse Pregnancy Outcomes during Pregnancy

摘要: 目的：本文旨在系统综述妊娠期血尿酸水平与各类妊娠结局(包括子痫前期、妊娠期糖尿病、胎儿生长异常、早产及辅助生殖结局)关系的最新研究进展，深入探讨其潜在的炎症、氧化应激、内皮功能障碍及表观遗传等分子机制。方法：检索并分析近年来国内外最新相关文献，重点围绕妊娠期尿酸水平的变化趋势，探讨其在不良妊娠结局发生与发展中的病理生理机制及临床意义。结果：本文概述了妊娠期尿酸代谢的生理与病理生理特点，阐明其从“代谢废物”向“损伤分子”的角色转变。表明尿酸不仅是肾功能损害的标志物，还直接参与子痫前期、胎儿生长异常、妊娠期糖尿病等疾病的发病过程，通过炎症反应、氧化应激、血管内皮损伤等机制影响妊娠结局。结论：现有证据强烈支持妊娠期高尿酸血症是多种不良母儿结局的关键风险因素，其监测与管理具有重要临床意义。未来研究应致力于确立妊娠期特异的尿酸参考值，构建多指标联合预测模型，并在人体中深入研究其致病通路，最终推动针对尿酸代谢的个体化、精准化防治策略的发展，以改善母婴近远期健康。

Abstract: Objective: This article aims to systematically review the latest research progress on the relationship between blood uric acid levels during pregnancy and various pregnancy outcomes, including preeclampsia, gestational diabetes, fetal growth abnormalities, preterm birth and assisted reproductive outcomes, and to explore the underlying molecular mechanisms such as inflammation, oxidative stress, endothelial dysfunction, and epigenetics. Methods: The latest literature at home and abroad was searched and analyzed, focusing on the trend of uric acid levels during pregnancy, and discussing its pathophysiological mechanism and clinical significance in the occurrence and development of adverse pregnancy outcomes. Results: This paper summarized the physiological and pathophysiological characteristics of uric acid metabolism during pregnancy, and clarified its role from “metabolic waste” to “damage molecule”. It is shown that uric acid is not only a marker of renal impairment, but also directly involved in the pathogenesis of preeclampsia, fetal growth and development, gestational diabetes and other diseases, and affects pregnancy outcomes through inflammatory response, oxidative stress, vascular endothelial damage and other mechanisms. Conclusion: The available evidence strongly supports that hyperuricemia in pregnancy is a key risk factor for a variety of adverse maternal and infant outcomes, and its monitoring and management are of clinical significance. Future research should focus on establishing pregnancy-specific uric acid reference values, constructing a multi-index joint prediction model, and conducting in-depth research on its pathogenic pathways in humans, ultimately promoting the development of individualized and precise prevention and treatment strategies for uric acid metabolism to improve the short- and long-term health of mothers and babies.