Preeclampsia is a multisystem disorder associated with pregnancy and is a common cause of perinatal morbidity. The aim of this study was to determine whether elevated serum uric acid levels, alone or in combination with other laboratory factors could predict preeclampsia in women with adverse perinatal outcomes.We conducted a prospective observational study of women who were admitted to Soonchunhyang University Cheonan Hospital from January 2016 to December 2016. Demographic, clinical and laboratory data were collected for each pregnancy at the time of delivery. Women were grouped according to status (preeclampsia or normotensive), and a logistic regression analysis was used to determine the relationship between serum uric acid levels and adverse outcomes.The mean age of the study participants was 31.3 ± 5.0 years. In patients with preeclampsia, serum uric acid level was associated with the severity of preeclampsia, including blood pressure (R = 0.321, P = .014), serum creatinine levels (R = 0.505, P < .001), and proteinuria (P = .014), as well as adverse fetal outcomes, including preterm labor (P = .027) and low birth weight delivery (P = .001). The optimal maternal serum uric acid threshold that predicted low birth weight at delivery was 6.35 mg/dL (sensitivity, 0.58; specificity, 0.95). The multivariable logistic regression model that was used to predict low birth weight at delivery displayed an area under the receiver-operating characteristic curve of 0.902 (95% confidence interval, 0.817-0.986).In women with preeclampsia, maternal serum uric acid level is an important parameter for predicting low birth weight. Additionally, the combination of uric acid, hemoglobin, and bilirubin levels appear to be optimal for predicting low birth weight in women with preeclampsia.