Riboflavin deficiency and preeclampsia

Objective: To examine in a prospective study riboflavin deficiency as a pre disposing factor for preeclampsia in a high-risk collective of pregnant wom en in Zimbabwe. Methods: At an antenatal clinic in Bulawayo, Zimbabwe, 154 women at increas ed risk for preeclampsia were observed prospectively until delivery. Ribofl avin status was determined using the erythrocyte glutathione reductase acti vation coefficient test on the day of antenatal booking. Riboflavin deficie ncy was expressed by erythrocyte glutathione reductase activation coefficie nt of 1.4 or greater. Results: Riboflavin deficiency was frequently found among the study populat ion (33.8%). Incidence rose toward the end of pregnancy (27.3% at 29-36 wee ks' gestation compared with 53.3% at over 36 weeks). In the riboflavin-defi cient group, mothers were more likely to develop preeclampsia (28.8%) than in the riboflavin-adequate group (7.8%; P <.001, odds ratio [OR] 4.7, 95% c onfidence interval [CI] 1.8-12.2). The calculated concentrations of intrace llular free flavin adenine dinucleotide were significantly lower in patient s who developed preeclampsia than in normal pregnancies (P <.05). Conclusion: Riboflavin deficiency should be considered a possible risk fact or for preeclampsia. Insufficient concentrations of the riboflavin-derived cofactors flavin adenine dinucleotide and flavin adenine mononucleotide cou ld contribute to the established pathophysiologic changes including mitocho ndrial dysfunction, enhanced oxidative stress, and disturbances in nitric o xide release. (Obstet Gynecol 2000; 96:38-44. (C) 2000 by The American Coll ege of Obstetricians and Gynecologists.).