Background: Hypertension is the most common medical problem encountered during pregnancy and is a major cause of maternal morbidity and mortality. Serum homocysteine-mediated vascular changes are similar to those associated with preeclampsia and, hence, hypothesized to be associated with this condition. The present study is being undertaken to study the association of serum homocysteine with pregnancy-induced hypertension (PIH) and folic acid supplementation.
Materials and methods: This is a prospective study conducted in a tertiary care teaching hospital in Punjab. The study was carried out for a period of 2 years. This study included 60 pregnant women, out of which 30 subjects were having hypertensive disorders of pregnancy and 30 were normotensive subjects. Fasting serum homocysteine levels were obtained, compared, and analyzed. The test was based on an immunoassay technique. The normal range of serum homocysteine was taken as 5–15 µmol/L.
Results: In this study, serum homocysteine levels were found to be higher in hypertensive subjects as compared to that in normotensive subjects. The levels of serum homocysteine were higher in severe forms of PIH in comparison to nonsevere forms. Also, the level of serum homocysteine was associated with folic acid supplementation.
Conclusion: In summary, the present study has shown an increased level of serum homocysteine in both mild and severe preeclampsia compared with normal pregnancy and a statistically significant association of total homocysteine concentrations with the severity of the disease.
Baumann MU, Bersinger NA, Surbek DV. Serum markers for predicting preeclampsia. Mol Aspects Med 2007;28:227–244.
Rajkovic A, Catalano PM, Malinow MR. Elevated homocyst(e)ine levels with preeclampsia. Obstet Gynaecol 1997;90:168–171.
Refsum H, Ueland PM, Nygard O, et al. Homocysteine and cardiovascular disease. Annu Rev Med 1998;49:31–62.
Patrick TE, Powers RW, Daftary AR, et al. Homocysteine and folic acid are inversely related in black women with Preeclampsia. Hypertension 2004;43:1279–1282.
Dekker GA, de Vries JI, Doelitzsch PM, et al. Underlying disorders associated with severe early-onset preeclampsia. Am J Obstet Gynecol 1995;173:1042–1048.
Goddijn-Wessel TAW, Wouters MGAJ, van de Molen EF, et al. Hyper-homocysteinemia: a risk factor for placental abruption or infarction. Eur J Obstet Gynaecol Reprod Biol 1996;66:23–29.
Hogeveen M, Blom HJ, den Heijer M, et al. Maternal homocysteine and small for gestational age offspring: systematic review and meta-analysis. Am J Clin Nutr 2012;95:130–136.
Makedos G, Papaniculaou A, Hitoglou A, et al. Homocysteine, folic acid and B12 serum levels in pregnancy complicated with pre eclampsia. Arch Gynecol Obstet 2007;275:121–124.
Powers RW, Evans RW, Ness RB, et al. Homocysteine and cellular fibronectin are increased in preeclampsia, not transient hypertension of pregnancy. Hypertens Pregnancy 2001;(20):69–77.
Zeeman GG, Alexander JM, Mcintire DD, et al. Homocysteine plasma concentration levels for the prediction of preeclampsia in women with chronic hypertension. Am J Obstet Gynecol 2003;189:574–576.
Qureshi SB, Ahmad M, Qureshi PM, et al. Hyperhomocysteinemia, vascular related pregnancy complications and the response to vitamin supplementation in pregnant women of Pakistan. J Pak Med Assoc 2010;60(9):741–745.
Leeda M, Riyazi N, de Vriesa JI, et al. Effects of folic acid and vitamin B6 supplementation on women with hyperhomocysteinemia and history of preeclampsia or fetal growth restriction. Am J Obstet Gynecol 1998;179:135–139.
Hasanzadeh M, Ayatollahi H, Farzadnia M, et al. Elevated plasma total homocysteine in preeclampsia. Saudi Med J 2008;29(6):875–878.
Ingec M, Borekci B, Kadanali S. Elevated plasma homocysteine concentrations in severe preeclampsia and eclampsia. Tohoku J Exp Med 2005;206(3):225–231
Singh U, Gupta HP, Singh RK, et al. A study of changes in homocysteine levels during normal pregnancy and pre-eclampsia. J Indian Med Assoc 2008;106(8):503–505.
Guven MA, Coskun A, Ertaz IE, et al. Association of maternal serum CRP, IL-6, TNF-ALPHA, homocysteine, folic acid and vitamin B12 levels with the severity of preeclampsia and fetal birth weight. Hypertens Pregnancy 2009;28:190–200.