HYPERHOMOCYSTEINEMIA - A RISK FACTOR FOR PLACENTAL ABRUPTION OR INFARCTION

Objective: To establish the prevalence of hyperhomocysteinemia in wome n with placental abruption or infarction. Design: Forty-six women with normal pregnancy outcome (controls) and 84 women with placental abrup tion or infarction (study group) were selected, and studied in the non -pregnant state, Homocysteine metabolism was investigated by a standar dized oral methionine loading test, Hyperhomocysteinemia was defined a s a concentration of fasting and/or postmethionine plasma homocysteine exceeding the estimated 97.5 percentile level of the controls. In the fasting state, the vitamin status was investigated by the measurement of serum and red cell folate, serum vitamin B12, and whole blood pyri doxal-5'-phosphate (PLP, an active form of vitamin B6). Results: Hyper homocysteinemia was diagnosed in four controls (9%) and 26 women of th e study group (31%, P < 0.05). The median concentrations of the vitami ns studied were significantly lower in women of the study group as com pared to the controls, except for red cell folate, where the median co ncentration was comparable in both groups. The median concentration of fasting plasma homocysteine, unlike post-methionine plasma homocystei ne, was significantly higher in women who experienced placental abrupt ion or infarction in their first pregnancy than in women who had the s ame event after one or more uncomplicated pregnancies. Conclusion: Hyp erhomocysteinemia is associated with placental abruption or infarction .