Homocysteine and cellular fibronectin are increased in preeclampsia, not transient hypertension of pregnancy

Objective. The objective of this study was to confirm that endothelial dysf unction is present in preeclampsia and absent in transient hypertension of pregnancy, and to determine whether the cardiovascular risk factor homocyst eine is associated with the degree of endothelial dysfunction. Methods. We measured cellular fibronectin (as a marker of endothelial injur y) and total plasma homocysteine in samples collected at the time of admitt ance to labor and delivery in 17 women with preeclampsia (increased blood p ressure, proteinuria, and hyperuricemia). 16 women with transient hypertens ion of pregnancy (only increased blood pressure), and 34 normal pregnant wo men. Each subject with preeclampsia was matched by prepregnancy body mass i ndex, race, and gestational age at delivery to one subject with transient h ypertension of pregnancy and two controls. Results. Cellular fibronectin was found to be significantly increased in wo men with preeclampsia compared to subjects with transient hypertension of p regnancy or normal pregnant women (22.9 +/- 14.1 mug/mL versus 10.9 +/-5.4 and 10.1 +/-6.2 mug/mL, respectively, p <0.0001). Similarly, total plasma h omocysteine was also significantly increased in the women with preeclampsia compared to subjects with transient hypertension of pregnancy or normal pr egnant women (8.3 +/-2.5 muM versus 5.5 +/-2.2 and 5.4 +/-3.4 muM respectiv ely, p <0.01). However, contrary to our hypothesis, there was no apparent a ssociation between cellular fibronectin and homocysteine. Conclusions. The increased concentrations of homocysteine observed in preec lampsia are not a general feature of ail hypertensive complications of preg nancy. Furthermore, endothelial dysfunction is present in preeclampsia and is not evident in transient hypertension of pregnancy. However, the apparen t endothelial dysfunction in preeclampsia is not explained by the increase in homocysteine concentrations observed.