Background The disorder of serum uric acid metabolism during pregnancy is associated with adverse pregnancy outcomes, while few studies have analyzed and compared the correlation of serum uric acid and serum uric acid/creatinine ratio levels with adverse pregnancy outcomes. Objective To explore the correlation of serum uric acid and serum uric acid/creatinine ratio levels with adverse pregnancy outcomes in late pregnancy. Methods A total of 743 pregnant women with singleton live births who were routinely examined and delivered at Nanjing Drum Tower Hospital from 2015 to 2022 were selected . Based on the occurrence of adverse pregnancy outcomes, pregnant women were divided into normal group (344 cases) and adverse outcome group (399 cases) . Serum uric acid and serum uric acid/creatinine ratio were divided into three levels by quartiles, respectively, including Q1 (serum uric acid359 μmol/L) and q1 (serum uric acid/creatinine ratio7.94) . According to the median age of pregnant women, they were divided into the age subgroup