Key result
Early second-trimester plasma homocysteine fails to predict preeclampsia or intrauterine growth restriction.
Why the study?
Increased plasma homocysteine levels have been reported in 20–30% of women with preeclampsia and may predict its development, but this predictive value is uncertain.
Do early second trimester plasma homocysteine levels predict the development of preeclampsia or intrauterine growth restriction in pregnant women?
Cohort (n=1,874)
Do early second trimester plasma homocysteine levels predict the development of preeclampsia or intrauterine growth restriction in pregnant women?
Early second trimester plasma homocysteine levels do not predict the development of preeclampsia or IUGR, although levels are elevated during overt preeclampsia.
Early second-trimester homocysteine testing should not guide preeclampsia or IUGR risk assessment; leaves open its utility once disease is established.
Background. Elevated circulating homocysteine is an independent risk factor for cardiovascular disease. Increased homocysteine plasma levels have been reported to occur in approximately 20–30% of women with preeclampsia and it has been suggested that they may predict the subsequent development of preeclampsia. Methods. In a cohort of 1874 pregnant women followed longitudinally, who participated in the Down screening program, 27 developed preeclampsia and 36 intrauterine growth restriction (IUGR). A control group of 63 uneventful pregnancies was selected. Plasma homocysteine was assayed in the early second trimester and at delivery in all groups. Data were compared with Wilcoxon's matched-pair test. Results. No statistically significant difference of plasma homocysteine between controls and preeclamptic or IUGR pregnancies in the early second trimester were found. There was a significant difference, only at delivery, between the preeclamptic subjects and the controls. Conclusions. We failed to demonstrate a plasma homocysteine predictive value in pregnancies subsequently complicated by preeclampsia and IUGR. As previously stated, we found that an elevated homocysteine plasma level is associated with overt preeclampsia.
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D’Anna et al. (2004) conducted a cohort in Preeclampsia and intrauterine growth restriction (n=1,874). Plasma homocysteine vs. Uneventful pregnancies (controls) was evaluated on Development of preeclampsia or intrauterine growth restriction. Plasma homocysteine levels in the early second trimester did not predict the subsequent development of preeclampsia or intrauterine growth restriction.
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