The aim of this study was to determine the relationship between maternal serum homocysteine levels in preeclampsia and the severity of the disease, neonatal serum homocysteine levels, maternal complications, and fetal outcome. Fifty pregnant women were included in this prospective study, of which 25 were severe (group I) and 25 were non-severe preeclamptic (group II). Maternal and neonatal serum homocysteine levels were measured by the fluorescence polarization immunoassay (FPIA) method. Maternal homocysteine levels in both groups were compared. The association of maternal and neonatal serum homocysteine levels with maternal complications and fetal outcome was investigated. When the maternal serum homocysteine cut-off value was accepted as 15 micromol/L, significant differences in relation to maternal (eclampsia; hemolysis, elevated liver enzymes, and low platelet count syndrome) and fetal (in utero mort fetalis, low birthweight) complications were observed between the group with maternal serum homocysteine level > 15 micromol/L and the group with maternal serum homocysteine level < or = 15 micromol/L ( p < 0.05). Hyperhomocysteinemia during pregnancy is a risk factor for both development of preeclampsia and its complications. Given that the diagnosis and treatment of hyperhomocysteinemia is possible, clinical trials to determine whether treatment to reduce homocysteine would be valuable in the prevention of both maternal and fetal complications in preeclampsia should be designed.

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The objective of this study was to evaluate the change in maternal serum leptin levels in preeclampsia and to study the relationship between maternal serum leptin and thyroid-stimulating hormone (TSH), body mass index (BMI), newborn weight, and proteinuria. Eighty-five pregnant women were included in this prospective study, of whom 50 were preeclamptic and 35 were normotensive. Maternal serum leptin levels were measured by the radioimmunoassay technique and TSH levels were measured by the electrochemiluminescence immunoassay method. The maternal serum leptin levels of preeclamptic and normotensive pregnant women were compared. In each group, the relationship between maternal serum leptin levels and TSH levels, BMI, newborn weight, and proteinuria was evaluated. The maternal serum leptin level was significantly higher in the preeclamptics than in the normotensive pregnant women. In the preeclamptic group, there was a strong positive correlation between maternal serum leptin levels and BMI (r =- 0.80; p < 0.001), a very weak positive correlation between maternal serum leptin levels and proteinuria (r = 0.305; p < 0.05), and a very weak inverse correlation between maternal serum leptin levels and birth weight (r = -0.377; p < 0.01). In the same group, there was no correlation between maternal serum leptin and serum TSH levels (r = 0.22; p > 0.05; Pearson correlation test). Leptin may be involved in the pathology of preeclampsia, and elevated maternal serum leptin levels may be a marker for the early stages of preeclampsia in pregnant women.

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PAPP-A level at last trimester increases in all mild-severe preeclampsia and HELLP syndrome, but is not predictive for severity of preeclampsia or HELLP syndrome.