Can high uric acid levels before 20 weeks predict gestational diabetes or pre-eclampsia?
Uric acid is a waste product in the blood. Some studies suggest that high levels early in pregnancy may signal future problems like gestational diabetes (GDM) or pre-eclampsia. A large 2024 study found that uric acid levels before 20 weeks are linked to GDM risk, but the evidence for predicting pre-eclampsia is less clear. Other factors and tests are also important for assessing your risk.
What the research says
A 2024 study of over 44,000 pregnant women found that higher uric acid levels before 20 weeks were linked to a greater chance of developing gestational diabetes. Women with uric acid between 240 and 360 μmol/L had 1.47 times the odds of GDM, and those with levels at or above 360 μmol/L had 2.60 times the odds, compared to women with levels below 240 μmol/L 1. The same study also found a link between high uric acid and GDM that required insulin, as well as GDM combined with pre-eclampsia 1. However, this study did not look at pre-eclampsia alone.
Other research on uric acid and pre-eclampsia has mixed results. A 2025 study that evaluated uric acid along with other biomarkers in women after 24 weeks of pregnancy found that uric acid was not as good at predicting pre-eclampsia as other tests like the sFlt-1/PlGF ratio 5. An older study from 1997 in women with severe pre-eclampsia found no clear link between high uric acid levels and worse outcomes for the baby 6. A 2022 study measured uric acid after 34 weeks and found it was higher in women with severe pre-eclampsia, but this was after the condition had already developed 7.
Overall, the strongest evidence is for uric acid as a predictor of gestational diabetes when measured early in pregnancy. For pre-eclampsia, the research is less consistent, and uric acid is not currently used alone to predict the condition. Other factors like blood pressure, protein in urine, and newer biomarkers are more reliable 5.
What to ask your doctor
- Should I have my uric acid level checked early in pregnancy to assess my risk for gestational diabetes?
- If my uric acid is high, what other tests or monitoring do you recommend?
- What are the most reliable ways to predict pre-eclampsia, and do I have any risk factors?
- How often should my blood pressure and urine be checked during pregnancy?
- Can lifestyle changes help lower my risk of gestational diabetes or pre-eclampsia?
This question is drawn from common patient questions about this topic and answered using cited medical research. We do not provide individualized advice.