Abstract
Introduction: Preeclampsia is among the leading causes of feto-maternal morbidity and mortality throughout the world, especially in developing countries like Pakistan. The exact pathophysiology of preeclampsia is still unclear but recent research on homocysteine shows its important role.
 Aims & Objectives: The aim of this study was to determine association of high serum homocysteine level with preeclampsia among antenatal women.
 Place and duration of study: Tertiary Care Hospitals of Lahore (Services, Lahore General Hospital and Sir Ganga Ram Hospitals) from 1st January 2019 to 30th June 2019.
 Material & Methods: A matched case-control design was employed. Sixty-six diagnosed pre-eclamptic antenatal women were selected as cases and they were age and gestational weeks matched with sixty-six normotensive antenatal women as control, with a case to control ratio of 1:1. Serum homocysteine level in fasting sample was estimated by Enzyme linked immuno assay. Data was entered and analyzed through SPSS version 20.
 Results: The mean plasma homocysteine was significantly higher in cases (16.05 ± 2.25) as compared to controls (9.44±2.83) with a p value <0.001. Highly Significant statistical association was found between Hyperhomocysteinemia and Preeclampsia (p-value < 0.001 with adjusted Odds Ratio of 4.72).
 Conclusion: Homocysteine levels a high in preeclamptic women as compared to normotensives showing that hyperhomocysteinemia is significantly associated with preeclampsia in antenatal women.
Highlights
Preeclampsia is among the leading causes of feto-maternal morbidity and mortality throughout the world, especially in developing countries like Pakistan
Homocysteine levels a high in preeclamptic women as compared to normotensives showing that hyperhomocysteinemia is significantly associated with preeclampsia in antenatal women
There was no statistically significant difference in mean age in both groups which showed that the age matching was appropriately done
Summary
Preeclampsia is among the leading causes of feto-maternal morbidity and mortality throughout the world, especially in developing countries like Pakistan. Preeclampsia is a pregnancy specific disorder defined as the combination of high blood pressure, (hypertension), swelling (edema) and protein in the urine (albuminuria/proteinuria), developing after the 20th week of pregnancy.[5] Preeclampsia has been recognized as significant leading cause of maternal morbidity along with perinatal mortality and these women are more prone to have cardiovascular disease in later life.[6] Reduced blood flow to placenta causes ischemia/hypoxia which is proposed to trigger the release of a various placental factors that have marked effects on arterial pressure regulation and blood circulation.[7] Preexisting hypertension, renal disease, strong family history of pre-eclampsia/eclampsia, systemic lupus erythematous and poor antenatal care are among predisposing/risk factors.[8,9] It has been proposed that the vasculature of pregnant mothers may show increased sensitivity to plasma level of homocysteine.[10] Homocysteine (Hhcy) is a non-essential amino acid that contains sulphur and it is derived from demethylation of methionine. Women with higher concentration of plasma homocysteine (hyperhomocysteinemia) levels during early pregnancy were found to have greater chance of developing preeclampsia and intrauterine growth restriction (IUGR).[7,13,14,15] Recent literature based on large cohorts and many case-control studies reports significant association between homocysteine concentrations in maternal serum during early pregnancy and adverse pregnancy outcome and changes in placental vasculature.[16,17] Current study was planned and conducted to identify the association as well as the strength of association between homocysteine levels and preeclampsia in local antenatal women of Lahore city
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