Elevated plasma homocysteine in early pregnancy: A risk factor for the development of severe preeclampsia

OBJECTIVE: The aim of our study was to determine if an elevated plasma homo cysteine level In early pregnancy is associated with the development of sev ere preeclampsia. STUDY DESIGN: Blood samples were obtained from patients attending their fir st antenatal visit. Cases were asymptomatic women who subsequently develope d severe preeclampsia. Controls were matched for gestational age and date o f sample collection. Plasma homocysteine level was measured by using fluore scence polarization immunoassay. RESULTS: There were 56 patients with severe preeclampsia from whom blood sa mples were obtained at a mean (+/- SD) gestation of 15.3 weeks (+/-4.04 wee ks) and 112 controls at 14.9 weeks (+/-3.41 weeks). The preeclampsia cases had a mean (+/- SD) homocysteine level of 9.8 mu mol/L (+/-3.3 mu mol/L), w hereas controls had a mean homocysteine level of 8.4 mu mol/L (+/-1.9 mu mo l/L), P less than or equal to .0001. CONCLUSION: Women who develop severe preeclampsia have higher plasma homocy steine levels in early pregnancy than women who remain normotensive through out pregnancy. An elevated plasma homocysteine level In early pregnancy can increase the risk of developing severe preeclampsia by almost threefold.