The evaluation of serum homocysteine, folic acid, and vitamin B12 in patients complicated with preeclampsia

Abstract

IntroductionIncreased plasma homocysteine may be associated with adverse pregnancy outcomes, such as preeclampsia. The aim of this study was to determine the plasma homocysteine, serum folate, and vitamin B12 levels in preeclamptic pregnant women.MethodsThis case-control study was conducted in 2016 in Ahwaz on 51 pregnant women with preeclampsia and 51 healthy pregnant women of the same gestational age, who served as controls. The case group also was subdivided into severe and non-severe preeclampsia. Patients’ data were collected through a questionnaire and medical records. Serum homocysteine, folic acid, and vitamin B12 were analyzed using chemiluminescent assay. The results were compared between two groups. Statistical analyses were done using IBM-SPSS 20.0. A Kolmogorov-Smirnov test, independent samples t-test, Mann-Whitney test, and Chi-square test were used for data analysis.ResultsNo different demographic characteristics were found among the groups. Pregnant women complicated with preeclampsia displayed significantly higher serum homocysteine levels (p < 0.001) and lower serum folate (p = 0.005) and vitamin B12 levels (p < 0.001) compared to controls. A statistically significant inverse correlation was evident between serum homocysteine and serum folate levels in preeclamptic patients (p = 0.005; r = −0.389). In addition, an inverse correlation was identified between homocysteine and serum vitamin B12, but it was not statistically significant (p = 0.160; r = −0.200). Significant differences occurred in serum homocysteine and folate levels between the severe and non-severe subgroups (p < 0.001, p < 0.001).ConclusionWomen complicated with preeclampsia displayed higher maternal serum homocysteine and lower serum folate and vitamin B12. Further studies are needed to confirm if the prescription of folic acid and vitamin B12 in women with a deficiency of these vitamins could decrease the level of serum homocysteine and, therefore, reduce the risk of preeclampsia or, if it occurred, its severity.

Serum homocysteine and folate concentrations in early pregnancy and subsequent events of adverse pregnancy outcome: the Sichuan Homocysteine study

“…Folate and VB12 are two vital regulators of the metabolism of Hcy [43]. A significant association is observed between maternal lower folate concentrations and higher Hcy levels as well as an increase in the risk of preeclampsia [44]. Furness et al [45] found that pregnant women with decreased red blood cell folate concentration and increased plasma concentrations of Hcy at 18-20 weeks of gestation had a higher risk of developing IUGR compared with controls (P < 0.001).…”

The Role of Nitric Oxide, ADMA, and Homocysteine in The Etiopathogenesis of Preeclampsia—Review

“…Folate and vitamin B12 serum levels were described as unchanged [132,134,135] in PE when comparing to normotensive healthy women with uncomplicated pregnancies. However, opposite results indicating these vitamins deficiencies were also reported [135,146]. Nevertheless, further studies are needed to confirm whether the prescription of these vitamins could decrease serum homocysteine, thereby possibly reducing the risk of preeclampsia or (if it occurs) its severity.…”

“…Still, most of the papers focus on the third trimester [93,130,132,133,134,135,137], where the differences between HHcys in severe and non-severe PE are marked. Pregnant women complicated with severe preeclampsia displayed significantly higher serum Hcy levels than with non-severe form [93,112,132,134,136,146]. Thus, homocysteine concentrations positively correlating with the clinical presentation of disease may constitute a marker of severity of preeclampsia.…”

Association between serum homocysteine level and unexplained infertility in in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI): A retrospective, hospital‐based, case‐control study

“…Previous studies have shown that Hcy concentration correlates with sperm, oocyte, and embryo qualities . Among 269 infertile women at a mean age of 37 ± 4 years, there were 69% presenting adequate plasma Hcy levels, and the pregnant women complicated with preeclampsia had significantly higher serum Hcy levels than healthy pregnant women at the same gestational age ( P < .001) . In addition, Hcy is reported to be inversely associated with fertility outcome, and lower Hcy levels have been found to correlate with a better chance of clinical pregnancy and better embryo grades in assisted reproductive technology (ART) .…”