Abstract

GOMEZ JIMENEZ, Jorge Mario; ZULETA TOBON, Jhon Jairo; CAMPUZANO MAYO, Germán  and  CORDOBA GOMEZ, Carlos Mario. Association between hyperhomocysteinemia and preeclampsia. Rev Colomb Obstet Ginecol [online]. 2002, vol.53, n.1, pp.71-78. ISSN 0034-7434.

OBJECTIVE: To explore the association between posprandial elevated serum levels of homocystein and preeclampsia and related complications before 35 weeks of gestational age. METHODOLOGY: Cross sectional study on 109 pregnant patients before 35 weeks of gestational age (group I, n = 55 pre-eclamptic patients (90,9% severe cases), and group II, n = 54 non pre-eclamptic patients) of the hospitals Universitario San Vicente de Paúl and General de Medellín, from September 1^st, 1999 to September 1^st, 2000. RESULTS: There were no differences between both groups when analyzing general characteristics. There was no correlation between homocystein, measured by fluorescent polarized immunoassay (FPIA) with pregnant patient age, gestational age no parity (Spearman's rho -0,057 - 0,074 - 0,17 respectively). There was a significant difference between medians of the homocystein concentration in compared groups: in G I it was 11,8 and 8,8 micromol/L in GII (p<0,01). Patients with homocystein level in the last quartile (>11.2 micromol/L) have a risk 9,67 times higher when compared with patients in the first quartile (Homocystein < 7,1) to present preeclampsia (p = 0,001). Percentile 95 for norm-tense pregnant patients was 13,025 micromol/L. This level was established like an end point for hyperhomocysteinemia definition in pregnant women; 25 (45,5%) in G I and 2 (3,37%) in G II of the patients were positive for hyperhomocysteinemia, odds ratio (OR) 21,67 (confidence interval 95% 4,48 - 142,66, p< 0,001). Fourteen group I patients had complications attributable to preeclampsia, 6 were positive women for hyperhomocysteinemia compared to 19 positive patients for hyper homocysteinemia of 41 without complications in the same group (p = 0,397). Thirteen of 25 intrauterine growth restriction (IUGR) events in G I compared to 12 patients of 30 without IUGR, were positive patients for hyperhomocysteinemia (p = 0,37). Six newborns of 26 women in group II that ended gestation in the source hospitals, presented intrauterine grow restriction but their mothers were negative for hyperhomocysteinemia. CONCLUSION: hyperhomocysteinemia was defined in pregnancy above p95, HC > 13,025 micromol/L and an association, though not causal, between hyperhoocysteinemia and preeclampsia was found.

Keywords : preeclampsia; homocystein; hyperhomocysteinemia.

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