The evaluation of serum homocysteine, folic acid, and vitamin B12 in patients complicated with preeclampsia
Keywords:
Homocysteine, Folic acid, Vitamin B12, PreeclampsiaAbstract
Introduction: Increased 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.
Methods: This 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.
Results: No 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).
Conclusion: Women 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.
References
Salam RA, Das JK, Ali A, Bhaumik S, Lassi ZS. Diagnosis and management of preeclampsia in
community setting in low and middle-income countries. J Family Med Prim Care. 2015; 4(4): 501-6. doi:
4103/2249-4863.174265. PMID: 26985406, PMCID: PMC4776599.
Shenoy V, Kanasaki K, Kalluri R. Pre-eclampsia: connecting angiogenic and metabolic pathways. Trends
Endocrinol Metab. 2010; 21(9): 529-36. doi: 10.1016/j.tem.2010.05.002. PMID: 20646932.
Brown MC, Best KE, Pearce MS, Waugh J, Robson SC, Bell R. Cardiovascular disease risk in women with
pre-eclampsia: systematic review and meta-analysis. Eur J Epidemiol. 2013; 28(1): 1-19. doi:
1007/s10654-013-9762-6. PMID: 23397514.
Altman D, Carroli G, Duley L, Farrell B, Moodley J, Neilson J, et al. Do women with pre-eclampsia, and
their babies, benefit from magnesium sulphate? The magpie Trial: A randomized placebo-controlled trial.
Lancet. 2002; 359(9321): 1877-90. doi: 10.1016/S0140-6736(02)08778-0. PMID: 12057549.
Hague WM. Homocysteine and pregnancy. Best Pract Res Clin Obstet Gynaecol. 2003; 17(3): 459-69. doi:
1053/S1521-6934)03)00009-91. PMID: 12787538.
Makedos G, Papanicolaou A, Hitoglou A, Kalogiannidis I, Makedos A, Vrazioti V, et al. homocysteine,
Folic acid and B12 serum levels in pregnancy complicated with preeclampsia. Arch Gynecol Obstet. 2007;
(2): 121-4. doi: 10.1007/s00404-006-0223-2. PMID: 16941105.
Acilmis YG, Dikensoy E, Kutlar AI, Balat O, Cebesoy FB, Ozturk E, et al. homocysteine, folic acid and
vitamin B12 levels in maternal and umbilical cord plasma and homocysteine levels in placenta in pregnant
women with pre-eclampsia. J Obstet Gynaecol Res. 2011; 37(1): 45-50. doi: 10.1111/j.1447- 0756.2010.01317.x. PMID: 21040211.
Dodds L, Fell DB, Dooley KC, Armson BA, Allen AC, Nassar BA, et al. Effect of homocysteine
concentration in early pregnancy on gestational hypertensive disorders and other pregnancy outcomes. Clin
Chem. 2008; 54(2): 326-34. doi: 10.1373/clinchem.2007.097469. PMID: 18070815.
Yanez P, Vasquez CJ, Rodas L, Duran A, Chedraui P, Liem KH, et al. Erythrocyte folate content and
serum folic acid and homocysteine levels in preeclamptic primigravidae teenagers living at high altitude.
Arch Gynecol Obstet. 2013; 288(5): 1011-15. doi: 10.1007/s00404-013-2851-7. PMID: 23609037.
Bergen NE, Jaddoe VW, Timmermans S, Hofman A, Lindemans J, Russcher H, et al. Homocysteine and
folate concentrations in early pregnancy and the risk of adverse pregnancy outcomes: the generation R
study. BJOG. 2012; 119(6): 739-51. doi: 10.1111/j.1471-0528.2012.03321.x. PMID: 22489763.
El-Khairy L, Vollset SE, Refsum H, Ueland PM. Plasma total cysteine, pregnancy complications, and
adverse pregnancy outcomes: the Hordaland homocysteine study. Am J Clin Nutr. 2003; 77(2): 467-72.
PMID: 12540409.
Fenech M, Atiken C, Rinaldi J. Folate, vitamin B12, homocysteine status and DNA damage in young
Australian adults. Carcinogenesis. 1998; 19(7): 1163-71. doi: 10.1093/carcin/19.7.1163. PMID: 9683174.
Var A, Yildirim Y, onur E, Kuscu NK, uyanik BS, Goktalay K, et al. Endothelial dysfunction in
preeclampsia. Increased homocysteine and decreased nitric oxide levels. Gynecol Obstet Invest. 2003;
(4): 221-4. doi: 10.1159/000074824. PMID: 14614253.
Murphy MM, Fernandez-Ballart JD. Homocysteine in pregnancy. Adv Clin Chem. 2011; 53: 105-37. doi:
1016/B978-0-12-385855-9.00005-9. PMID: 21404916.
Wadhwani NS, Patil VV, Mehendale SS, Wagh GN, Gupte SA, Joshi SR. Increased homocysteine levels
exist in women with preeclampsia from early pregnancy. J Matern Fetal Neonatal Med. 2016; 29(16):
-25. doi: 10.3109/14767058.2015.1102880. PMID: 26552939.
Megahed MA, Taher IM. Folate homocysteine levels in pregnancy. Br J Biomed Sci. 2004; 61(2): 84-7.
PMID: 15250671.
Mignini LE, Latthe PM, Villar J, Kilby MD, Carroli G, Khan KS. Mapping the theories of preeclampsia:
the role of homocysteine. Obstet Gynecol. 2005; 105(2): 411-25. doi:
1097/01.AOG.0000151117.52952.b6. PMID: 15684173.
Rajkovic A, Mohamed K, Malinow MR, Sorenson TK, Woelk GB, Williams MA. Plasma homocysteine
concentration in eclamptic and preeclamptic African women postpartum. Obstet Gynecol. 1999; 94(3):
-60. doi: 10.1097/00006250-199909000-00007. PMID: 10472859.
Sanlikan F, Tufan F, Gocmen A, Kabadayi C, Sengul E. The evaluation of homocysteine level in patients
with preeclampsia. Ginekol pol. 2015; 86(4): 287-91. doi: 10.17772/gp/2075. PMID: 26117988.
Mujawar SA, Patil VW, Daver RG. Study of serum homocysteine, folic acid and vitamin B12 in patients
with preeclampsia. Ind J Clin Biochem. 2011; 26(3): 257-60. doi: 10.1007/s12291-011-0109-3. PMID:
, PMCID: 3162959.
Published
Issue
Section
License
Copyright (c) 2020 KNOWLEDGE KINGDOM PUBLISHING
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.