Changes in Serum Homocysteine Concentrations and their Prognostic Value in Pregnant Chinese Women with Preeclampsia : A Retrospective Study

Background: This study evaluated whether changes in homocysteine concentrations in pregnant women with preeclampsia might be useful for predicting pregnancy-related outcomes.Methods: This retrospective study evaluated 2,745 pregnant Chinese women (1,368 women with preeclampsia and 1377 healthy pregnant controls) at two Chinese centres. Medical records were reviewed to collect data regarding maternal age, homocysteine concentrations, gestational weight gain, body mass index (BMI), neonatal weight, Apgar score, previous abortions, previous deliveries, adverse pregnancy history, and pregnancy-related outcomes.Results: Maternal serum homocysteine concentrations were significantly higher in the preeclampsia group (vs. the control group) during the second trimester (P<0.0001) and the third trimester (P<0.0001). Foetal death was also significantly more common in the preeclampsia group. Significant differences (P<0.05) were also observed between the preeclampsia and control groups in terms of maternal age, gestational weight gain, BMI, neonatal weight, Apgar score, previous abortions, previous deliveries, gestation length, adverse pregnancy history, and pregnancy outcomes. Women with preeclampsia had elevated homocysteine concentrations that increased from the first trimester until the third trimester. Among women with preeclampsia, the risk of foetal death was significantly associated with maternal age, BMI, neonatal weight, Apgar score, and serum homocysteine concentrations during the second trimester (P=0.022) and the third trimester (P=0.034). Conclusion: Our results indicate that foetal death in women with preeclampsia was associated with maternal age, BMI, neonatal weight, and Apgar score. Furthermore, foetal death was associated with high maternal homocysteine concentrations during the second and third trimesters.