RESUMO
Homocysteine, the demethylated derivative of the essential amino acid, methionine, is regulated by several factors. Elevated levels during pregnancy are associated with an increased incidence of spontaneous abortion, intrauterine growth restriction, placental infarction and neural tube dejects. Pre-eclampsia was added to this list of homocysteine-related pregnancy complications. The aim of this study was to determine the value of second trimester plasma homocysteine levels in the prediction of pre-eclampsia. This prospective study included 168 healthy primigravidae with singleton gestation from those attended the antenatal care clinic at Mansoura and Benha University Hospitals. Blood samples were obtained at their antenatal visits between 16 - 20 weeks. Plasma homocysteine was measured by enzyme immunoassay. The participants were followed up clinically till delivery for subsequent development of preeclampsia. The mean [ +/- SD] homocysteine level at 18.4 +/- 2.0 weeks gestation in women who developed pre-eclampsia [Group I] was significantly higher than those who did not develop pre-eclampsia [Group II] [10.2 micromol/ L +/- 3.6 micromol /L versus 8.2 micromol / L +/- 1.6 micromol/L respectively: p < 0.001]. Those patients with plasma homocysteine level of> 12 micromol / L in early pregnancy had an increased risk for developing pre-eclampsia by almost two and half folds. Also, plasma homocysteine level showed significant negative correlation with serum folic acid. An elevated second trimester plasma homocysteine level is associated with increased risk for subsequent development of pre-eclampsia. Also, the significant negative correlation between plasma homocysteine and serum folic acid levels may offer a hope for the use of folic acid supplements to prevent the development of pre-eclampsia in high risk pregnancies