A study of homocysteine level at the III trimester of pregnancy
Keywords:Homocysteine level, primigravida, estrogen, methionine
Background: Homocysteine is an amino acid which has sprung into prominence in the past few decades. Levels of maternal serum homocysteine normally decreases with gestation, either due to a physiological response to the pregnancy, increase in estrogen, haemodilution from increased plasma volume or increased demand for methionine by both the mother and fetus.
Methods: A prospective randomized controlled clinical trial of 50 patients was carried out in Kamla Raja Hospital and outpatient Department of Gajra Raja Medical College, Gwalior from October 6th to October 2007, which was further categorized into socio-demographic and clinical factors.
Results: Out of 50 patients, it was found that there were 31(62%) cases below the age of 25 years whereas 19(38%) cases were above the age of 25 years, 30(60%) cases were educated below the primary level whereas 20(40%) cases were educated above the primary level, 10(20%) cases belonged to rural areas whereas 40(80%) cases belonged to the urban areas. According to the socio economic distribution, 11(22%) cases were below class II whereas 39(78%) cases were above class II. According to distribution of parity, 22(44%) cases were below primigravida whereas 28(56%) cases were above primigravida.Conclusions: This study concludes that mean of Serum Levels in pregnant women with socio-demographic and clinical factors was statistically insignificant which signifies that age, education, residential areas and hemoglobin are not the factors contributing to the rise in homocysteine level in pregnant women. The diastolic and systolic blood pressure is weakly correlated with serum homocysteine level.
Forges T, Monnier-Barbarino P, Alberto JM, Guéant-Rodriguez RM, Daval JL, GuéantJL. Impact of folate and homocysteine metabolism on human reproductive health. Hum Reprod Update. 2007;13(3):225-38.
Kramer MS, Kahn SR, Rozen R. Vasculopathic and thrombophilic risk factors for spontaneous preterm birth. Int J Epidemiol. 2009;38(3):715-23.
Meigs JB, Jacques PF, Selhub J. Fasting plasma homocysteine levels in the insulin resistance syndrome. Diabetes Care. 2001;24(8):1403-10.
Sydow K, Schwedhelm E, Arakawa N, Bode-Boger SM, Tsikas D, Horning B, et al. ADMA and oxidative stress are responsible for endothelial dysfunction in hyperhomocysteinemia: Effects of L-arginine and B vitamins. Cardiovasc Res. 2003;57:244-58.
Walker MC, Smith GN, Perkins SL, Keely EJ, Garner PR. Changes in homocysteine level in normal pregnancy. Am J Obstet Gynecol. 1999;180:660-4.
Ray JG, Laskin CA. Folic acid and homocysteine metabolic defects and the risk of placental abruption, pre-eclampsia and spontaneous pregnancy loss: A systemic review. Placenta. 1999;20:519-29.
Powers R, Evans R, Majors A. Plasma homocysteine concentration is increased in pre-eclampsia and associated with evidence of endothelial activation. Am J Obstet Gynecol. 1998;179:1605-11.
Ackurt F, Wetherilt H, Loker M, Hacibekiro M. Biochemical assessment of nutritional status in pre- and post-natal Turkish women and outcome of pregnancy. Eur J Clin Nutr. 1995;49:613-22.
Mudd SH, Levy HL, Skovby F. Disorders in transsulfuration. In: Scriver CR, Beaudet AL, Sly WS, Valle D, eds. The metabolic and molecular basis of molecular disease. New York: McGraw-Hill. 1995:1279-327.
Picciano MF. Is homocysteine a biomarker for identifying women at risk of complications and adverse pregnancy outcomes? Am J Clin Nutr. 2000;71:857-8.
Vollset SE, Refsum H, Irgens LM. Plasma total homocysteine, pregnancy complications and adverse pregnancy outcomes: The Hordaland Study. Am J ClinNutr. 2000;71:962-8.
Zhu BPl, Rolfs RT, Nangle BE, Horan JM. Effect of the interval between pregnancies on perinatal outcomes. N Engl J Med. 1999;340:589-94.
Selhub J, Jacques PF, Bostom AG. Association between plasma homocysteine concentrations and extracranial carotid-artery stenosis. N Engl J Med. 1995;332:286-91.
Sebastio G, Sperandeo MP, Panico M. The molecular basis of homocystinuria due to cystathionine β-synthase deficiency in Italian families and report of four novel mutations. Am J Hum Genet. 1995;56:1324-33.
Morrison HI, Schaubel D, Desmeules M, Wigle DT. Serum folate and risk of fatal coronary artery disease. JAMA. 1996;275:1893-6.
MacMahon S, Peto R, Cutler J. Blood pressure, stroke, and coronary artery disease: Part 1, prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias. Lancet. 1990;335:765-74.