TLR4 and infection: Uric acid has antioxidant activity at physiological levels, but when it accumulates can take on a crystalline particulate form that results in oxidative damage and activates inflammation via TLR4.30 Similar effects of elevated amniotic fluid uric acid originating in fetal urine occur in the placenta and gestational tissues, where uric acid induces IL‐1β in trophoblasts via inflammasome activation.95 A large cohort study has linked maternal hyperuricemia during the third trimester of pregnancy with preterm delivery, in women where infection and other clinical risk factors were absent.96