Plasma homocyst(e)ine concentrations in eclamptic and preeclamptic Africanwomen postpartum

Objective: To examine the relationship between plasma homocyst(e)ine and ri sk of eclampsia and preeclampsia among sub-Saharan African women who delive red at Harare Maternity Hospital in Zimbabwe. Methods: We ran a hospital-based, case-control study at Harare Maternity Ho spital, University of Zimbabwe, Harare, Zimbabwe comprising 33 pregnant wom en with eclampsia and 138 with preeclampsia. Controls were 185 normotensive pregnant women. Plasma was collected postpartum and homocyst(e)ine levels were measured by high-performance liquid chromatography and electrochemical detection. Results: Women with eclampsia or preeclampsia had significantly higher mean homocyst(e)ine levels than normotensive controls (12.54 or 12.77 mu mol/L versus 9.93 mu mol/L, respectively, P < .001). The odds ratio (OR) for ecla mpsia was 6.03 among women in the highest quartile of the control homocyst( e)ine distribution (median 13.9 mu mol/L) compared with women in the lowest quartile (median 6.2 mu mol/L). The corresponding OR for preeclampsia was 4.57. Nulliparas with elevated homocyst(e)ine had a 12.90 times higher risk of preeclampsia compared with multiparas without elevated homocyst(e)ine. Conclusion: Postpartum plasma homocyst(e)ine concentrations are higher amon g Zimbabwean women with eclampsia and preeclampsia compared with normotensi ve women. (C) 1999 by The American College of Obstetricians and Gynecologis ts.