Homocysteine plasma concentration levels for the prediction of preeclampsia in women with chronic hypertension.
OBJECTIVE
The purpose of this study was to evaluate prospectively midtrimester homocysteine concentration levels for the prediction of superimposed preeclampsia in women with chronic hypertension.


METHODS
Between March 1, 2000, and February 1, 2002, pregnancies that were complicated by chronic hypertension that required medication had homocysteine, vitamin B(12), and folate concentrations measured between 16 and 20 weeks of gestation. All women received folate supplementation. An upper limit threshold for increased homocysteine was defined as the mean value plus 2 SDs.


RESULTS
Fifty-seven women were enrolled. Mean homocysteine concentration levels were 5.1+/-1.7 micromo/L for the 16 women who had preeclampsia compared with 4.7+/-1.3 micromo/L for the 41 women without preeclampsia (P=.56). Two of 16 women with preeclampsia (13%) had concentration levels that exceeded the 95th percentile (6.9 micromo/L) compared with 2 of 41 women (5%) without preeclampsia (P=.31). The sensitivity and specificity were 13% (95% CI, 1.6-38.3) and 95.1% (95% CI, 83.5-99.4), respectively.


CONCLUSIONS
Second-trimester homocysteine concentration levels were not helpful in the prediction of preeclampsia in chronically hypertensive women.
Zeeman
Gerda G
GG
Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas, USA. veth-zeeman@planet.nl
Alexander
James M
JM
McIntire
Donald D
DD
Devaraj
Sridevi
S
Leveno
Kenneth J
KJ
D000328:Adult; D016022:Case-Control Studies; D002908:Chronic Disease; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D006973:Hypertension / Q000150:complications*; D009994:Osmolar Concentration; D011225:Pre-Eclampsia / Q000209:etiology*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D011262:Pregnancy Trimester, Second; D011379:Prognosis; D011446:Prospective Studies; D012680:Sensitivity and Specificity
D006710:Homocysteine