Association of maternal serum homocysteine level with severity of preeclampsia: a case control study

Yelikar, Kanan; Deshpande, Sonali; Kulkarni, Manisha

doi:10.18203/2320-1770.ijrcog20162653

Cited by 10 publications

(13 citation statements)

References 7 publications

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“…The present study observed that the mean homocysteine levels in normotensive group, preeclampsia and eclampsia group was 8.70±2.64 µmol/L, 16.43±9.27 µmol/L and 24.44±13.29 µmol/L respectively. The mean homocysteine level in normotensives, pre-eclampsia and eclampsia patients observed in present study was comparable to the observations made in the studies conducted by Yelikar 4,9,12,[16][17][18][19] Moreover, as we moved from lower severity to higher severity in the spectrum of hypertensive disorders of pregnancy the homocysteine level kept increasing. This finding further commensurates pregnancy induced hypertension with the homycysteinemia and supports our hypothesis that serum homocysteine is raised in preeclampsia and there is an association between preeclampsia and hyperhomocysteinemia.…”

Section: Discussionsupporting

confidence: 90%

“…3 The incidence of preeclampsia is 5-7% of all pregnancies. 4 The incidence of eclampsia varies widely and it seen more in primigravida, twin pregnancies and in more than half of the cases it occurs between the 36 th week and term. 3 In addition to elevated blood pressure, proteinuria, and convulsions these disorders are further characterized by ominous impaired liver function, increased serum uric acid, decreased platelet count and signs and symptoms such as headache, visual disturbance, epigastric pain and pulmonary odema.…”

Section: Introductionmentioning

confidence: 99%

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Can serum homocysteine predict hypertensive disorders of pregnancy?: an evidence from a case control study in a North Indian tertiary health care institution

Pathania

Verma

Chamotra

et al. 2019

Int J Reprod Contracept Obstet Gynecol

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Background: Hypertensive disorders of pregnancy are a major cause of both maternal and foetal morbidity and mortality. Although pregnancy induced hypertension (PIH) is still regarded as a disease of theories and unknown etiology, elevated homocysteine level has been hypothesized as a key risk factor. Abnormally raised homocysteine has been significantly associated with increased risk of PIH, abruption, intrauterine growth restriction, recurrent pregnancy loss, intrauterine death and prematurity.Methods: The present case control study was conducted among 180 pregnant women (90 cases and 90 controls) in Kamla Nehru State Hospital for Mother and Child, IGMC Shimla, Himachal Pradesh with an objective of ascertaining the role of homocysteine in pregnancy related hypertensive disorders. Socio-demographic, clinical, biochemical including homocysteine level, laboratory and ultrasonographic parameters of all the participants were documented.Results: The mean homocysteine level of cases (18.30±10.81) was significantly higher than the controls (8.70±2.64). About 62.2% cases had abnormally raised homocysteine level (>15 µmol/L), while only 1.1% controls had such level. The odds of a case having abnormally elevated homocysteine level were 146.6 (CI: 19.52-1101) times to that of controls. Eclamptics had the highest homocysteine level followed by preeclamptics and controls.Conclusions: The present study significantly associates the abnormally elevated homocysteine levels with pregnancy related hypertensive ailments and demands much needed robustly designed studies to further explore the phenomenon. A simple intervention like estimating the much neglected homocysteine levels prior to pregnancy can definitely aid in predicting and preventing perinatal outcomes.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Can serum homocysteine predict hypertensive disorders of pregnancy?: an evidence from a case control study in a North Indian tertiary health care institution

Pathania

Verma

Chamotra

et al. 2019

Int J Reprod Contracept Obstet Gynecol

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show abstract

“…1 In line with this study, many studies have demonstrated the relationship between hyperhomocysteinemia and preeclampsia. 21,22 Usually the homocysteine level gets decreased during pregnancy due to various factors. In second and third trimester total plasma homocysteine in maternal plasma is decreased by 50 percent than non-pregnant women.…”

Section: Discussionmentioning

confidence: 99%

Potential role of serum homocysteine and uric acid level as a predictive marker for pre-eclampsia

et al. 2019

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Among pregnant women worldwide, 7-15% develops pre-eclampsia; approximately 1-2% will develop eclampsia. The Nepal Maternal Mortality and Morbidity study 2008/2009 revealed that 21% maternal death was due to eclampsia, which was increased from 14% in 1998. 2,3 Uric acid is an end product of purine metabolism. Studies have shown that uric acid can be considered as a pathogenic factor in Preeclampsia. Hyperuricemia prevailing in pre-eclampsia has been attributed to either a ABSTRACT Background: Hypertension is one of the common disorders during pregnancy and can cause severe health complications for both mother and developing fetus. Pre-eclampsia (PE) is a form of hypertensive disorder complicating pregnancy. This study was aimed to estimate serum uric acid and homocysteine level as a potential biomarker for prediction of preeclampsia. Methods: 85 pre-eclamptic pregnant women and 50 normotensive pregnant women were recruited from department of Obstetrics and Gynecology, Star Hospital after obtaining the informed written consent. Blood samples were collected and analyzed for serum homocysteine and serum uric acid level. Results: Serum uric acid and homocysteine levels were found to be significantly higher in pre-eclamptic cases than in controls (6.5±0.7 mg/dl and 13.5±5.4 µmol/l in cases versus 4.3±0.8 mg/dl and 10.1±4.6 µmol/l in healthy controls). Maximum sensitivity and specificity of serum uric acid was obtained at a cut-off of 5.5 mg/dl (sensitivity-91% and Specificity-88%) and serum homocysteine at 10.7 µmol/l (sensitivity-67% and specificity-64%) respectively. Conclusions: At optimum cut off value serum uric acid showed highest sensitivity and specificity for diagnosis of pre-eclampsia. Thus, serum uric acid level is better predictive marker compared to serum homocysteine level for preeclampsia.

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“…Homocysteine is involved in processes such as lipid peroxidation, oxidative stress and endothelial dysfunction and thereby resulting in pre-eclampsia. 3 The present study is aimed at the estimation of serum homocysteine concentration in both pregnancy related hypertensive disorders and normotensive pregnant women, thereby reducing its relation in causation of preeclampsia.…”

mentioning

confidence: 99%

“…Homocysteine may prove to be the missing link in the etiology of pre-eclampsia. 3 Further, hyperhomocysteinemia may also be an important biological marker for adverse outcome of pregnancy and even possibly a cause of or a contributor to the complications of pregnancy. 4…”

mentioning

confidence: 99%

Correlation of serum homocysteine levels in pregnancy related hypertensive disorders versus normotensive pregnancies

Hymavathi

Shukla

Madhuri

2020

Int J Reprod Contracept Obstet Gynecol

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Background: Homocysteine concentrations decrease during normal pregnancy, but this does not occur in pre-eclampsia. In pre-eclampsia, homocysteine levels further increase with severity of pre-eclampsia. Elevated homocysteine levels can be due to genetic or multifactorial deficit or a combination of both.Methods: The present study is conducted at department of obstetrics and gynaecology, Narayana Medical College and Hospital, Nellore. 200 pregnant (100 women with pregnancy related hypertensive disorders and 100 normotensive pregnants) recruited. Maternal serum Homocysteine levels were analyzed among women with pregnancy related hypertensive disorders and compared with normotensive pregnant. Chemiluminescence immunoassay was used for determining the Homocysteine levels.Results: The study revealed significant elevation in the levels of homocysteine in pre-eclamptic women (17.54±5.34) compared to normotensive women (7.59±1.91). The study showed a strong association between serum homocysteine levels and severity of pre-eclampsia. The mean homocysteine levels in women with severe Pre-eclampsia (20.59±4.3) were significantly higher than those with mild pre-eclampsia (15.17±1.9). A positive correlation is found between homocysteine levels with serum uric acid and LDH demonstrating the harmful action of hyperhomocysteinemia upon the endothelium. A negative correlation is found between homocysteine levels with hemoglobin and hematocrit even though in anemic patients the hematological levels are found to be little high due to hemoconcentration. The perinatal outcome in women with raised levels of homocysteine was poor with an increased incidence of IUGR (41%), SGA (9%), still births (3%) and IUD (4%) among women with pregnancy related hypertensive disorders when compared to normotensive pregnant women.Conclusions: Elevated levels of homocysteine can be reduced by administering vitamins which help by increasing the metabolism of homocysteine. The internationally accepted treatment for hyperhomocystenemia is using a combination of folic acid 400 µg, vitamin B12 500 µg and pyridoxine 10mg initiating from pre-conceptional period can be used.

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Association of maternal serum homocysteine level with severity of preeclampsia: a case control study

Cited by 10 publications

References 7 publications

Can serum homocysteine predict hypertensive disorders of pregnancy?: an evidence from a case control study in a North Indian tertiary health care institution

Can serum homocysteine predict hypertensive disorders of pregnancy?: an evidence from a case control study in a North Indian tertiary health care institution

Potential role of serum homocysteine and uric acid level as a predictive marker for pre-eclampsia

Correlation of serum homocysteine levels in pregnancy related hypertensive disorders versus normotensive pregnancies

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