Hyperhomocysteinemia in Recurrent pregnancy loss

Nisha Bhatia, Hemanshu B.


Background: Hyperhomocysteinemia is associated with many pregnancy related complications. Its association with recurrent pregnancy loss has been investigated recently. Not only it is associated with recurrent pregnancy loss but also associated with complications like Preeclampsia, intrauterine growth retardation and low birth weight. The objective of this study to assess the prevalence of Hyperhomocysteinemia in patients with unexplained recurrent pregnancy loss and to evaluate the association of hyperhomocysteinemia with pregnancy complications in patients of recurrent pregnancy loss.

Methods: 50 Patients of unexplained recurrent pregnancy loss were selected as cases and 50 patients with atleast one successful pregnancy were taken as controls. Their blood sample was assayed for Fasting Homocysteine levels. They were followed up throughout pregnancy for any complications and neonatal outcome was recorded.

Results: 19 patients out of the 50 cases had Hyperhomocysteinemia. Hyperhomocysteinemia was thrice more common in Primary aborters when compared to secondary aborters. Out of 19 patients with hyperhomocysteinemia in patients with recurrent pregnancy loss, 14 patients also developed Hypertensive disorder of pregnancy during their antenatal period. Among patients with Hyperhomocysteinemia in study group, 47% had low birthweight babies when compared to 25% among control group.

Conclusions: Hyperhomocysteinemia is associated with recurrent pregnancy loss and patients of Recurrent pregnancy loss who have Hyperhomocysteinemia have a higher risk of developing pregnancy complications like Preeclampsia, low birth weight and Intrauterine growth retardation.


Hyperhomocysteinemia, Hypertensive disorders, Intrauterine growth restriction, Low birth weight, Plasma homocysteine, Primary aborter

Full Text:



Carington B, Sacks G, Regan C. Recurrent Miscarriage pathophysiology and outcome. Curr Opin Obstet Gynecol. 2005;17:591-7.

Fatini C, Gensini F, Battaglini B, Prisco D, Cellai AP, Fedi S et al. Angiotensin converting enzyme DD genotype, angiotensin type 1 receptor Cc genotype and hyperhomocysteinemia increase first trimester fetal loss and susceptibility. Blood Coagul Fibrinolysis. 2000;11:657-62.

Yajnik CS, Deshpande SS, Jackson AA, Refsum H, Rao S, Fisher DJ et al. Vitamin B12 and Folate concentrations during pregnancy and insulin resistance in the offspring: the Pune Maternal Nutrition study. Diabetologia. 2008;51:29.

Kumar J, Das SK, Sharma P, Karthikeyan G, Ramakrishnan L, Sengupta S. Homocysteine levels are associated with MTHFR A 1298C polymorphism in Indian population. J Human Genetics. 2005;50:655-63.

Nelen WL, Blom HJ, Steegers EA, den Heijer M, Thomas CM, Eskes TK. Homocysteine and Folate levels as risk factors for REPL. Obstet Gynecol. 2000;95(4):519-24.

Coumans AB1, Huijgens PC, Jakobs C, Schats R, de Vries JI, van Pampus MG. Haemostatic and metabolic abnormalities in women with unexplained recurrent abortion. Hum Reprod. 1999;14(1):211-4.

Wouters MG1, Boers GH, Blom HJ, Trijbels FJ, Thomas CM, Borm GF et al. Hyperhomocystenemia is a risk factor in women with unexplained REPL. Fertil Steril.1993;60(5):820-5.

Del Bianco A, Maruotti G, Fulgieri AM, Celeste T, Lombardi L, Amato NA et al. Recurrent spontaneous miscarriages and Hyperhomocysteinemia. Minerva Ginecol. 2004;56(5):379-83.

Misra A, Vikram NK, Pandey RM, Dwivedi M, Ahmad FU, Luthra K et al. Hyperhomocysteinemia and intake of folic acid and Vitamin B12 in urban North India. Eur J Nutr. 2002;41:68-77.

Vollset SE, Refsum H, Irgens LM Emblem BM, Tverdal A, Gjessing HK et al. Plasma total homocysteine, pregnancy complications and adverse pregnancy outcome: the Hordland homocysteine study. Am J Clinical Nutr. 2000;71:962-8.