European Journal of Cardiovascular Medicine

Background: Gestational Diabetes Mellitus (GDM) is a prevalent metabolic disorder during pregnancy, carrying significant health risks for both mothers and infants. Early detection and risk assessment are crucial for effective management. This study investigates the potential of first-trimester serum uric acid levels as an early predictor of GDM in pregnant women attending a tertiary care hospital in Uttar Pradesh, India. Material and Methods: A prospective cohort study was conducted, enrolling 500 pregnant women in their first trimester. Clinical data, including demographic information, medical history, and anthropometric measurements, were collected. Laboratory measurements of uric acid, fasting glucose, and insulin resistance indices were performed. Participants were followed throughout pregnancy, and GDM diagnosis was established using the standard oral glucose tolerance test (OGTT) during the second trimester. Statistical analysis included logistic regression, ROC curve analysis, and calculation of sensitivity, specificity, and predictive values. Results: Elevated first-trimester serum uric acid levels exhibited a significant association with GDM development. Participants with uric acid levels between 4.0 - 4.5 mg/dL had an odds ratio of 1.82 (95% CI: 1.51-2.21) compared to those with levels below 4.0 mg/dL, indicating increased GDM risk. Uric acid levels > 4.5 mg/dL showed a sensitivity of 85% but a specificity of 68%. Combining uric acid with traditional risk factors, such as maternal age and BMI, may enhance predictive accuracy. Conclusion: First-trimester serum uric acid levels are a potential early predictor of GDM. Elevated uric acid levels were associated with increased GDM risk, though specificity may benefit from a multi-factorial predictive model. This study underscores the clinical significance of uric acid in GDM risk assessment and highlights the potential for improved screening strategies.