Study of Serum Homocysteine, Folic Acid and Vitamin B12 in Patients with Preeclampsia

Abstract

The present study was carried out to evaluate the occurrence of association between homocysteine, folic acid and vitamin B 12 in patients with preeclampsia. Fifty preeclamptic patients from gynecology ward were studied for estimation of serum homocysteine, folic acid and vitamin B 12 over a period of October 2007 to June 2010. Serum homocysteine and folic acid, and vitamin B 12 were determined by means of Immulite 1000 analyzer. The statistical analysis of study group of preeclampsia compared with normotensive control group, showed significant alterations in serum homocysteine, folic acid and vitamin B 12 concentrations in preeclampsia. Inverse association between serum homocysteine and folic acid, and vitamin B 12 levels were observed in preeclampsia. The present study found hyperhomocysteinemia and deficiency of folic acid and vitamin B 12 along with increased blood pressure as a risk factor for cardiovascular disease (CVD) in preeclampsia.

Hyperhomocysteinemia in pre-eclampsia: is routine screening rational?

“…7 Several other studies were in consonance with the present study. 5,6,[8][9][10] On the contrary Zeeman GG et al did not agree with our observations and there was no significant difference in maternal serum levels of homocysteine between pre-eclampsia and normal pregnancy (5.1±1.7 μmol/l vs 4.7±1.3 μmol/l p value =0.56) and they stated that serum homocysteine levels were not helpful in the prediction of PE. 11 Hietala R et al also stated that there was no difference between pre-eclampsia and normotensive women (6.42, 7.55μmol/l vs 6.45, 7.34 μmol/l).…”

Folic Acid Supplementation During Early Pregnancy and the Risk of Gestational Hypertension and Preeclampsia

“…[7][8][9]14,26,27 In addition, 2 prospective cohort studies did not observe a lower risk of hypertensive disorders of pregnancy with a greater intake of folate during the first trimester or between 13 and 21 weeks gestation. 28,29 The interest in folic acid for the prevention of cardiovascular disease stems from its critical role in lowering plasma homocysteine, which was found to be associated with a higher risk of cardiovascular disease in epidemiological studies.…”

“…30 Many studies in past decades showed that women with gestational hypertension or preeclampsia had a significant elevation of homocysteine postpartum, in the third trimester, in the second trimester, or even in early pregnancy. [5][6][7][8][9][10] Taking into consideration this emerging evidence, in combination with other data implicating hyperhomocysteinemia as an independent risk factor for vascular disease, some researchers hypothesized that hyperhomocysteinemia might be an independent risk factor for gestational hypertension. 6,12 However, recent trials have failed to demonstrate a benefit of lowering homocysteine for cardiovascular disease.…”

“…4 Many studies have observed a significant elevation of plasma or serum homocysteine among women with gestational hypertension or preeclampsia during pregnancy or postpartum, suggesting that homocysteine may be an independent risk factor for these disorders. [5][6][7][8][9][10][11][12] Some studies, however, did not support this causal association. 13,14 Hyperhomocysteinemia usually can be corrected by supplementation with folic acid.…”

Use of folic acid during pregravid preparation and pregnancy

“…Повышение уровня гомоцистеина значимо в патогенезе атеросклероза, ише-мической болезни сердца, инсульта, венозного тромбоза, нейродегенеративных заболеваний, остеопоротических переломов [19,20]. Эндотелиальная дисфункция, возни-кающая при гипергомоцистеинемии, является фактором патогенеза осложнений беременности, зависящих от ми-кроциркуляции, начиная с самопроизвольного выкиды-ша в I триместре беременности и заканчивая преэкламп-сией, преждевременной отслойкой плаценты и антена-тальной гибелью плода [21,22].…”