Correlation between maternal serum uric acid, cystatin C, and coagulation indices during pregnancy and clinical features of early-onset pre-eclampsia and its prognostic analysis

Objective This study investigated the relationship of maternal serum uric acid, cystatin C (CysC), and coagulation indices [international normalized ratio (INR) and fibrinogen (FIB)] during pregnancy with clinical features and prognosis of early-onset pre-eclampsia. Methods Patients with pre-eclampsia ( n = 133) were retrospectively selected, with clinical features and maternal uric acid, CysC, INR, and FIB levels collected. The relationship between clinical features and maternal uric acid, CysC, INR, and FIB was analyzed by Pearson’s and Spearman’s analyses. The receiver operating characteristic curve was used to analyze the discriminative power of maternal uric acid, CysC, INR, and FIB during pregnancy for the adverse maternal and infant outcomes. Results In patients with early-onset pre-eclampsia, uric acid and CysC levels positively correlated with mean arterial pressure (MAP) at diagnosis and 24-h proteinuria quantification. FIB negatively correlated with MAP at diagnosis, while INR did not significantly correlate with MAP at diagnosis and 24-h proteinuria quantification. Severe early-onset pre-eclampsia patients and early-onset pre-eclampsia patients with adverse maternal and perinatal outcomes had elevated maternal uric acid and CysC and decreased INR and FIB expression. These four indices were independently correlated with maternal and infant prognoses and had certain discriminative power, while their combination had higher discriminative power for adverse maternal and infant outcomes, which was significantly higher than that of disease severity alone. Conclusion The combined detection of uric acid, CysC, INR, and FIB had high discriminative power for adverse maternal and infant outcomes in patients with early-onset pre-eclampsia, significantly surpassing the discriminative power of clinical disease severity.