Association of maternal serum homocysteine level with severity of preeclampsia: a case control study

Kanan Avinash Yelikar, Sonali Satish Deshpande, Manisha Laxmikant Kulkarni


Background: The objective of the study was to investigate plasma levels of homocysteine in women with preeclampsia and eclampsia, and to assess whether there is any association between hyperhomocysteinemia and the severity of preeclampsia.

Methods: In this case control study, 120 women were recruited in the study in which 40 cases of preeclampsia, 40 cases of eclampsia and 40 healthy normotensive women were taken as controls between the study period September 2013 to August 2015. Assessment of homocysteine level was done in cases and controls. Association was studied between maternal homocysteine level and preeclampsia and eclampsia and also with the severity of pre-eclampsia.

Results: There was a significant association between pre-eclampsia and eclampsia and maternal serum homocysteine levels (median homocysteine level 16.25moμl/lit with P-value being less than 0.001 for preeclampsia ; median homocysteine level-31.34 μmol/lit with p value being less than 0.001 for eclampsia). There was also a significant association between severity of preeclampsia and maternal homocysteine level (mean serum homocysteine level in nonsevere preeclampsia 14.99±3.47 μmol/lit with p value being 0.35; in severe preeclampsia 19.90±6.17 μmol/lit with p value less than 0.001 and 30.44±4.75 μmol/lit with p value less than 0.001.

Conclusions: In the present study a positive association was found between pre-eclampsia and maternal serum homocysteine levels and it was found to be statistically significant. Also the levels were higher as the severity of preeclampsia increased. 


Eclampsia, Pre-eclampsia, Maternal serum homocysteine level

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Fernando A. Hypertensive disorders in pregnancy. In: Practical guide to high risk pregnancy and delivery. 3rd eds. Philadelphia: Mosby; 1994:183-207.

Report of National high blood pressure education programme working group on high blood pressure in pregnancy.

Gary CF, Leveno KJ, Bloom SL, Hauth JC, Gilstrap L, Wenstorm KD. Pregnancy hypertension. In: William Obstetrics, 23rd Ed. New York: McGraw Hill; 2005:706-14.

Ueland PM, Homocysteine species as components of plasma redox thiol status. Clin Chem. 1995;41:340-2.

Malinow MR, Boston AG, Krauss RM, Homocysteine, diet and cardiovascular diseases: A statement for healthcare professionals from the Nutrition Committee, American Heart Association. Circulation. 1999;99:178-82.

Walker MC, Smith GN, Perkins SL, Keely EJ, Garner PR. Changes in homocysteine levels during normal pregnancy. Am J Obstet Gynecol. 1999;180:660-4.

Hogg BB, Tamura T, Johnston KE, DuBard MB, Goldenberg MA, Goldenberg RL. Second-trimester plasma homocysteine levels and pregnancy-induced hypertension, preeclampsia, and intrauterine growth restriction. Am J Obstet Gynecol. 2000;183:805-9.

Vollset SE, Refsum H, Irgens LM, Emblem BM, Tverdal A, Gjes-sing HK, Monsen AL, Ueland PM. Plasma total homocysteine, pregnancy complications, and adverse pregnancy outcomes: the Hordaland Homocysteine study. Am J Clin Nutr. 2000;71:962-8.

Laskowaka M. Analysis of the homocysteine levels in maternal serum in pregnancies complicated by severe preeclampsia. Lublin Poland;2010.

Ingec M. Elevated Plasma Homocysteine Concentrations in Severe Preclampsia and Eclampsia:Tohoku J Exp Med. 2005;206:225-31.

Javadi EHS. The relationship between the level of homocysteinemia in mother’s serum and the intensity of preeclampsia. Life Science Journal. 2012;9(4).

Khosrowbeygi A. Circulating levels of homocysteine in preclamptic women: Bangladesh Med Res Bull. 2011;106-9.

Acilmis YG. Homocysteine , folic acid and vitamin B12 levels in maternal and umbilical cord plasma and homocysteine levels in placenta in pregnant women with preeclampsia. J Obstet Gynecol Res. 2011;37(1):45-50.

Dudani AL, Khoja A, Karira KA. Assessment of Homocysteine levels in preclampdia. Med Chanel. 2006;12(2):16-8.