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Plasma Homocyst(e)ine Concentrations in Eclamptic and Preeclamptic African Women Postpartum

From the Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas; Departments of Obstetrics and Gynecology and Community Medicine, University of Zimbabwe, School of Medicine, Harare, Zimbabwe; Division of Pathobiology and Immunology, Oregon Regional Primate Research Center, Beaverton, Oregon; Center for Perinatal Studies, Swedish Medical Center, Seattle, Washington; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; and Department of Epidemiology, University of Washington, School of Public Health and Community Medicine, Seattle, Washington.

Address reprint requests to: Aleksandar Rajkovic, PhD, MD Department of Molecular and Human Genetics Baylor College of Medicine One Baylor Plaza T617 Houston, TX 77030 E-mail: rajkovic{at}bcm.tmc.edu

Objective: To examine the relationship between plasma homocyst(e)ine and risk of eclampsia and preeclampsia among sub-Saharan African women who delivered at Harare Maternity Hospital in Zimbabwe.

Methods: We ran a hospital-based, case-control study at Harare Maternity Hospital, University of Zimbabwe, Harare, Zimbabwe comprising 33 pregnant women with eclampsia and 138 with preeclampsia. Controls were 185 normotensive pregnant women. Plasma was collected postpartum and homocyst(e)ine levels were measured by high-performance liquid chromatography and electrochemical detection.

Results: Women with eclampsia or preeclampsia had significantly higher mean homocyst(e)ine levels than normotensive controls (12.54 or 12.77 µmol/L versus 9.93 µmol/L, respectively, P < .001). The odds ratio (OR) for eclampsia was 6.03 among women in the highest quartile of the control homocyst(e)ine distribution (median 13.9 µmol/L) compared with women in the lowest quartile (median 6.2 µmol/L). The corresponding OR for preeclampsia was 4.57. Nulliparas with elevated homocyst(e)ine had a 12.90 times higher risk of preeclampsia compared with multiparas without elevated homocyst(e)ine.

Conclusion: Postpartum plasma homocyst(e)ine concentrations are higher among Zimbabwean women with eclampsia and preeclampsia compared with normotensive women.

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