Maternal Plasma Homocysteine Level, 24-Hour Urinary Protein and Haemoglobin in Pre-eclamptic Patients: is there Any Relationship?

Abstract

Background:  Anemia is very common in developing countries especially during pregnancy. Hyperhomocysteinemia can result from genetic or nutrient-related disturbances in the transsulfuration or remethylation pathway for homocysteine metabolism. Inadequate intake of vitamin B₁₂, B₆ or folate may underlie some cases of elevated homocysteine levels. The aim of this study was to investigate the possible relationship between plasma homocysteine level, haemoglobin level and 24-hour urinary protein in pre-eclamptic patients. Folic acid deficiency is one of the major cause of hyperhomocysteinemia which is one of the major risk factor for pre-eclampsia (PET). Severe proteinuria of several grams/day occurs in pre-eclamptic toxaemia.

Methods:  A cross-sectional comparative study was carried out on 90 primigravidae attending the "antenatal clinic" of Services Hospital, Lahore. Out of these 60 primigravidae 30 were mildly pre-eclamptic and 30 were severely pre-eclamptic at 30-38 weeks of pregnancy.30 primigravida [30-38 weeks of pregnancy] having uncomplicated pregnancy were taken as control.

Results:  The results show that in mild PET and in severe PET, the plasma homocysteine level shows a significant relationship with 24-hour urinary protein and hemoglobin level.

Conclusion:  Anemia [folic acid deficiency] is one of the important risk factor in the causation of hyperhomocysteinemia which is one of the major chronic risk factors for eclampsia.

Key-Words:  Hyperhomocysteinemia, anemia, mild PET, severe PET.