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

Abstract

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.

Homocysteine as a prognostic indicator for women with pregnancy-induced hypertension-a proportional study of homocysteine levels in normal versus pre-eclamptic women.

“…Preeclampsia is labeled by hypertension and urinary protein excretion typically start after 20 weeks in pregnant women and may increases the risk of poor consequences for mother / infant and some time may results eclampsia. 1 Globally the incidence of pre-eclampsia was 7-15%. However, in under developed countries like in Pakistan is 9.3%, in India 10.3% and in Nigeria, the incidence rate is 10.2%.…”