A case control study to compare the levels of homocysteine in normal and complicated pregnancies

Hyperhomocysteinemia during pregnancy is known to cause endothelial dysfunction as a result of increased oxidative stress or direct toxic effects. The purpose of this study is to find the correlation between Hyperhomocysteinemia and various placental dysfunctional related pregnancy complications.

A prospective case control study of 100 women admitted in antenatal ward or Labour room of department of OBG was conducted at Shri B.M. Patil Medical College Hospital and research center Vijayapur. Study Group consisted of 70 pregnant women with different pregnancy complications like Pre eclampsia, Eclampsia, unexplained Abruption, FGR with oligohydramnios and unexplained oligohydramnios. Control Group was of 30 healthy pregnant women. Fasting Homocysteine level was checked in all participants.

Mean level of Homocysteine was significantly raised in all patients with pregnancy complications (study group-26.4 umol/l) compared to patients without complications (control group-8.4 μmol/L) with a p value of <0.05. Significantly more number of patients had Hyperhomocysteinemia in each of pregnancy complication compared to control group (p<0.05). Among them, Eclampsia group had the highest mean value of 29.40 μmol/L followed by unexplained abruption (24.60 μmol/L), Pre Eclampsia (22.05 μmol/L), FGR with oligohydramnios (21.90 μmol/L) and unexplained oligohydramnios (20.90 μmol/L). Patients with high levels of Homocysteine also had poor pregnancy outcome.

In our study serum Homocysteine levels were significantly elevated in various pregnancy complications compared to control group. Patients with Hyperhomocysteinemia also had poor pregnancy outcome. Hence a strong correlation may exist between serum Homocysteine levels and complications of pregnancy related to placental dysfunction.

Supplementation of folic acid, vitamin B6 and vitamin B12 up to the completion of placentation or throughout pregnancy may be useful to prevent such complications.