Oxidative Stress and Nutrient Imbalance in Pre-eclampsia: The Roles of Homocysteine and Vitamin B12

Objectives: Pre-eclampsia is a pregnancy-related disorder characterized by hypertension and organ dysfunction, posing significant risks to both mother and fetus. While the exact etiology remains unclear, evidence suggests that biochemical alterations particularly oxidative stress, homocysteine, and vitamin B12 dysregulation play a pivotal role. This study explores the interplay between oxidative stress, homocysteine, and vitamin B12 in pre-eclampsia. Methods: This hospital-based cross-sectional study enrolled a total of 120 patients categorized into three groups: 40 pregnant women with pre-eclampsia, 40 healthy pregnant women matched for gestational age, and 40 healthy non-pregnant women matched for age. Serum malondialdehyde (MDA) levels were assessed using the Thiobarbituric Acid Reactive Substances (TBARS) assay. Homocysteine and vitamin B12 levels were measured via chemiluminescent immunoassay. Clinical parameters including blood pressure, proteinuria, liver enzymes, platelet counts, and serum uric acid were also evaluated. Data were analyzed using SPSS version 24. Results: Preeclamptic women exhibited significantly elevated serum MDA (2.84±0.30 nmol/mL) and homocysteine (20.21±2.78 µmol/L), with markedly reduced vitamin B12 (179.1±31.78 pg/mL), compared to both control groups (p<0.0001). MDA and homocysteine showed positive correlations with blood pressure, protein-creatinine ratio, and serum uric acid, while vitamin B12 was inversely correlated with MDA. Conclusion: The interplay of increased oxidative stress, elevated homocysteine, and reduced vitamin B12 levels appears to play a significant role in the pathogenesis of pre-eclampsia. These findings highlight the importance of early biochemical screening to identify at-risk women and open the possibility for preventive strategies such as antioxidant therapy and vitamin B12 supplementation. However, given the multifactorial nature of pre-eclampsia, robust longitudinal and large-scale prospective studies are essential to validate these associations, clarify underlying mechanisms, and translate them into clinically effective interventions.