Publication:

Hyperhomocysteinemia in pre-eclampsia: is routine screening rational?

Background Hypertensive disorders complicate upto 5 to 10% of all pregnancies. Though the exact cause of pre-eclampsia is still undecided, maternal hyperhomocysteinemia has been implicated as a risk factor for pre eclampsia, placental abruption and other vascular diseases. The objectives of present study were to estimate the levels of serum homocysteine in antenatal patients and to study the above parameters in patients of pre-eclampsia.

Methods A prospective observational study was performed with 30 pre eclamptic patients and an equal number taken as control having comparable demographic characteristics. Level of homocysteine was measured by an enzymatic method, using Diazyme homocysteine 2 reagent enzymatic assay kit on Beckman coulter analyzer in all the patients. Obstetrics and neonatal outcomes were observed in all the patients. The statistical analysis was done using unpaired T test for determining level of significance.

Results Mean Serum homocysteine in the study group was 13.99±5.46 µmol/l and was 6.03±2.58 µmol/l in control group. This was statistically significant (p value 0.002). However the mean values of serum homocysteine did not correlate with severity of pre-eclampsia 14.32±6.72 µmol/l in mild pre-eclampsia and 13.60±3.77μmol/l in severe pre-eclampsia respectively (p value - 0.727).

Conclusions It appears that maternal serum homocysteine has a causal role in pathogenesis of pre eclampsia, however to recommend it as a routine test, larger studies are required.