Plasma folate, vitamin B-12, and homocyst(e)ine concentrations in preeclamptic and normotensive Peruvian women

The authors measured maternal third trimester plasma folate, vitamin B-12, and homocyst(e)ine concentrations among 125 women with preeclampsia and 179 normotensive women in Lima, Peru (1997-1998), to determine whether these a nalytes were associated with the occurrence of preeclampsia. Logistic regre ssion procedures were used to calculate maximum likelihood estimates of odd s ratios and 95% confidence intervals. Relative to women in the upper quart ile of the control distribution of maternal plasma folate concentrations, w omen with values in the lowest quartile experienced a 1.6-fold increased ri sk of preeclampsia (odds ratio = 1.6; 95% confidence interval: 0.8, 3.2). T here was no evidence of an increased risk of preeclampsia associated with l ow plasma vitamin B-12 concentrations. The unadjusted relative risk of pree clampsia increased across successively higher quartiles of plasma homocyst( e)ine level (odds ratios were 1.0, 1.0, 1.5, and 2.9, respectively, with th e lowest quartile used as the referent; p for linear trend = 0.0004). After adjustment for maternal age, parity, gestational age, use of prenatal vita mins, whether the pregnancy had been planned, and educational attainment, t he relative risk between extreme quartiles was 4.0 (95% confidence interval : 1.8, 8.9). These findings are consistent with earlier reports suggesting that hyperhomocyst(e)inemia in pregnancy may be a risk factor for preeclamp sia.