Elevated plasma homocysteine in early pregnancy: a risk factor for the development of nonsevere preeclampsia.

OBJECTIVE: We have recently demonstrated that an elevated plasma homocysteine in early pregnancy is associated with the development of severe preeclampsia. The aim of this study was to determine whether an elevated plasma homocysteine in early pregnancy is also associated with the development of nonsevere preeclampsia. STUDY DESIGN: Blood was obtained from patients attending for a first antenatal visit. Subjects were asymptomatic women who subsequently developed nonsevere preeclampsia. Controls were matched for parity, gestational age, and date of sample collection. Plasma homocysteine was measured using fluorescence polarization immunoassay. RESULTS: There were 71 cases of nonsevere preeclampsia sampled at a mean gestational age (+/-SD) of 15.9+/-3.6 weeks and 142 controls at 15.6+/-3.4 weeks. The preeclampsia cases had a mean (+/-SD) homocysteine level of 8.4+/-2.4 micromol/L, whereas controls had a mean homocysteine of 7.07+/-1.5 micromol/L (P</=.0001). CONCLUSION: Women who develop nonsevere preeclampsia have higher plasma homocysteine levels in early pregnancy compared with women who remain normotensive throughout pregnancy. An elevated plasma homocysteine value in early pregnancy may be associated with a 4-fold increased risk for development of nonsevere preeclampsia.