Predicting pregnancy outcomes from homocysteine level: an evidence from a North Indian study

Chamotra, Shaina; Pathania, Kushla; Verma, Suman; Chaudhary, Ankit

doi:10.18203/2320-1770.ijrcog20201212

Cited by 4 publications

(5 citation statements)

References 9 publications

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“…A statistically significant difference was found between the two groups with respect to mean serum Hct levels (p < 0.001). This was supported by the research carried out by Chamotra et al (2020), where the mean Hct level in the increased and normal Hct groups were 23.26 ± 10.77 micromol/L and 8.99 ± 2.47 micromol/L respectively with statistically significant difference (p < 0.001) [8].…”

Section: Discussionsupporting

confidence: 55%

Maternal Hyperhomocysteinemia as a Predictor of Placenta-Mediated Pregnancy Complications: A Two-Year Novel Study

Memon¹,

Acharya²,

Acharya³

et al. 2023

Cureus

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BackgroundPlacenta-mediated pregnancy complications (PMPCs) are a significant contributor to adverse maternal and fetal outcomes. Though the exact cause of the array of pregnancy-related vascular disorders is still unknown, increased maternal serum homocysteine (Hct) levels have been linked to the pathophysiology. Hyperhomocysteinemia (HHct) has been strongly linked with the risk of developing PMPCs such as preeclampsia (PE), fetal growth restriction (FGR), intrauterine fetal death (IUFD), preterm births and placental abruption. MethodologyThe present observational study was carried out on 810 low-risk antenatal women in their early second trimester (13-20 weeks gestation age) in the department of obstetrics and gynecology of a tertiary care rural hospital to identify the significance of abnormally raised maternal serum Hct level in developing PMPCs. ResultsOf the 810 participants studied, 224 (27.65%) had raised Hct levels whereas the rest of the 586 (72.35%) participants had normal Hct levels. The mean Hct level of raised homocysteine group (18.59 ± 2.46 micromol/L) was substantially raised than the normal Hct group (8.64 ± 3.1 micromol/L). It was observed that women with elevated serum Hct levels developed PMPCs significantly more than women with normal serum Hct levels (p-value <0.05). Among HHct subjects, 65.18% developed PE, 34.38% had FGR, 28.13% had a preterm delivery, 4.02% had abruptio placentae and 3.57% had IUFD. ConclusionsThe focus of the current study is on an easy and quick intervention such as assessing the often-ignored levels of Hct during pregnancy that can help predict and prevent PMPCs. It also highlights the necessity for well-thought-out large-scale studies and trials to further examine the phenomena, as pregnancy may be the only time when rural women will have the opportunity to receive advice and to be tested for HHct.

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Section: Discussionsupporting

confidence: 55%

Maternal Hyperhomocysteinemia as a Predictor of Placenta-Mediated Pregnancy Complications: A Two-Year Novel Study

Memon¹,

Acharya²,

Acharya³

et al. 2023

Cureus

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“…In a study conducted by Gaiday et al [14], the majority of the population had a mean gestational age of 12 weeks, and Chamotra et al involved women with 20 weeks of gestation as the study population, whereas in the current study, among both groups, the majority of females had a gestational age of 10 weeks [12]. In a study by Mascarenhas et al, there was no statistical correlation between other associated factors and placenta-mediated complications [15].…”

Section: Discussioncontrasting

confidence: 49%

“…Ghike et al described that the total sample size was 60, out of which 17 (28%) women had low levels, 26 (43%) had raised levels, and 17 (28%) had normal homocysteine levels [11]. Similarly, in a study by Chamotra et al, 31% of women had raised values, whereas 68% of women had normal levels of homocysteine [12].…”

Section: Discussionmentioning

confidence: 95%

Raised Maternal Homocysteine Levels in Antenatal Women at 10 to 14 Weeks of Gestation and Placenta-Mediated Complications: A Cohort Study

Thakur¹,

Bhalerao²

2023

Cureus

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BackgroundPlacenta-mediated complications, such as preeclampsia, placental abruption, and fetal growth restriction, can indeed lead to significant maternal and perinatal morbidity and mortality. Early detection and management of these conditions are crucial to ensuring optimal outcomes for both the mother and baby. However, there have been inconsistent correlations found between maternal homocysteine levels and placenta-related problems in various studies. Therefore, prospective research based on data pointing to a role for hyperhomocysteinemia in placenta-mediated complications will open doors for early detection and management of these complications. Thus, this study aims to determine if a higher risk of placentamediated problems is connected with a higher maternal plasma homocysteine content between 10 and 14 weeks of gestation. MethodologyAn observational prospective cohort study was conducted in the Department of Obstetrics and Gynecology, consisting of all the antenatal women between 10 and 14 weeks of gestation attending outpatient departments or inpatients admitted in labor rooms or wards having singleton pregnancies. Along with socio-demographic information and detailed history, a clinical examination was performed, and blood samples were collected to determine plasma homocysteine levels. ResultsAs per the receiver operating characteristic curve (ROC curve), the cut-off value taken was <5 for the low level of serum homocysteine, 5 to 15 micromol/L for the normal value, and >15 micromol/L for a raised serum homocysteine level. The cutoff value for our study was 45 micromol/L with a sensitivity of 78.33%, a specificity of 91.67%, a positive predictive value of 90.38%, and a negative predictive value of 80.88% with a diagnostic accuracy of 85%. This means that, for most of the women included in the present study, those who developed placenta-mediated complications had serum blood homocysteine levels of 45 micromol/L or more at 10-14 weeks of gestation. ConclusionWomen with high homocysteine levels in the late first trimester had more placenta-mediated complications, such as abruption, pre-eclampsia, restricted fetal growth, and recurrent pregnancy losses, compared to women with a normal level of homocysteine in the late first trimester. Therefore, measuring blood homocysteine levels in pregnancy may be helpful as a diagnostic test for the early detection of high-risk individuals for placenta-mediated complications.

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“…Because HHcy is a risk factor for vascular diseases examined by our group and other investigators in humans, mouse models, and cell culture (Devlin et al, 2005;Perła-Kaján et al, 2008;Kim et al, 2011;Huang et al, 2012;Gurda et al, 2015), we hypothesize that elevated Hcy may be a potential marker of placental vascular disease. It was reported before that unusually high Hcy levels are linked in humans to pregnancy-related hypertension disorders and unfavorable pregnancy outcomes, including spontaneous abortions (Chamotra et al, 2020), fetal growth restriction, and preeclampsia (Chen et al, 2018;Gaiday et al, 2018). The mechanism by which HHcy may affect embryo development is insufficient remodeling of the spinal arteries and impaired angiogenesis in the placenta (Burton and Jauniaux, 2018).…”

Section: Discussionmentioning

confidence: 99%

Diet-induced hyperhomocysteinemia causes sex-dependent deficiencies in offspring musculature and brain function

Suszyńska-Zajczyk,

Witucki,

Perła-Kaján

et al. 2024

Front. Cell Dev. Biol.

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Hyperhomocysteinemia (HHcy), characterized by elevated homocysteine (Hcy) levels, is a known risk factor for cardiovascular, renal, and neurological diseases, as well as pregnancy complications. Our study aimed to investigate whether HHcy induced by a high-methionine (high-Met) diet exacerbates cognitive and behavioral deficits in offspring and leads to other breeding problems. Dietary HHcy was induced four weeks before mating and continued throughout gestation and post-delivery. A battery of behavioral tests was conducted on offspring between postnatal days (PNDs) 5 and 30 to assess motor function/activity and cognition. The results were correlated with brain morphometric measurements and quantitative analysis of mammalian target of rapamycin (mTOR)/autophagy markers. The high-Met diet significantly increased parental and offspring urinary tHcy levels and influenced offspring behavior in a sex-dependent manner. Female offspring exhibited impaired cognition, potentially related to morphometric changes observed exclusively in HHcy females. Male HHcy pups demonstrated muscle weakness, evidenced by slower surface righting, reduced hind limb suspension (HLS) hanging time, weaker grip strength, and decreased activity in the beaker test. Western blot analyses indicated the downregulation of autophagy and the upregulation of mTOR activity in HHcy cortexes. HHcy also led to breeding impairments, including reduced breeding rate, in-utero fetal death, lower pups’ body weight, and increased mortality, likely attributed to placental dysfunction associated with HHcy. In conclusion, a high-Met diet impairs memory and cognition in female juveniles and weakens muscle strength in male pups. These effects may stem from abnormal placental function affecting early neurogenesis, the dysregulation of autophagy-related pathways in the cortex, or epigenetic mechanisms of gene regulation triggered by HHcy during embryonic development.

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Predicting pregnancy outcomes from homocysteine level: an evidence from a North Indian study

Cited by 4 publications

References 9 publications

Maternal Hyperhomocysteinemia as a Predictor of Placenta-Mediated Pregnancy Complications: A Two-Year Novel Study

Maternal Hyperhomocysteinemia as a Predictor of Placenta-Mediated Pregnancy Complications: A Two-Year Novel Study

Raised Maternal Homocysteine Levels in Antenatal Women at 10 to 14 Weeks of Gestation and Placenta-Mediated Complications: A Cohort Study

Diet-induced hyperhomocysteinemia causes sex-dependent deficiencies in offspring musculature and brain function

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