Uterine artery Doppler and mid-trimester maternal plasma homocysteine in subsequent pre-eclampsia.
OBJECTIVE
To investigate whether mid-trimester maternal plasma homocysteine concentration is elevated in women who develop pre-eclampsia and in those women identified at high risk by abnormal uterine artery Doppler examination.


METHODS
This was a multicenter study involving healthy women undergoing screening for pre-eclampsia by uterine artery Doppler velocimetry at 22-24 weeks' gestation. Abnormal uterine artery blood flow was defined as a mean pulsatility index (PI) above the 95th centile (1.6). Controls (mean PI < 1.6) were matched for gestational age and date of blood sample collection. Maternal plasma homocysteine concentration was measured retrospectively using a chemiluminescent immunoassay.


RESULTS
In total, 683 women were recruited. Maternal plasma homocysteine concentration did not vary with gestation. Maternal plasma homocysteine concentration in women who subsequently developed pre-eclampsia (n = 80, 12%) was not significantly different from women with uncomplicated pregnancies (n = 536, 78%) (median 5.1, range 2.7-14.1 micromol/l vs. median 5.5, range 1.9-27.9 micromol/l, p = 0.44). There were no significant differences in the maternal plasma homocysteine concentration in women with abnormal uterine artery Doppler findings (n = 275) compared with controls (n = 408), (median 5.6, range 2.6-17.7 micromol/l vs. median 5.4, range 1.9-27.9 micromol/l, p = 0.13).


CONCLUSIONS
Mid-trimester maternal plasma homocysteine concentration is not elevated in women who developed pre-eclampsia even in those at high risk defined by abnormal uterine artery Doppler velocimetry.
Yu
C K H
CK
Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, Medical School, London, UK.
Lakasing
L
L
Papageorghiou
A T
AT
Spencer
K
K
Nicolaides
K H
KH
D000293:Adolescent; D000328:Adult; D001158:Arteries / Q000502:physiology; D004739:England; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008875:Middle Aged; D011225:Pre-Eclampsia / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D011237:Predictive Value of Tests; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011296:Prenatal Diagnosis; D011673:Pulsatile Flow; D012039:Regional Blood Flow; D016216:Ultrasonography, Prenatal; D014599:Uterus / Q000098:blood supply*
D006710:Homocysteine