The Correlation between Serum Level of Homocysteine in Women with Gestational Diabetes and Adverse Pregnancy Outcome

Abstract

ABSTRACT
Background: Homocysteine is a common amino acid found in the body, while it is not
harmful in normal levels, when those levels get too high especially during pregnancy, it
can cause a condition called hyperhomocysteinemia. Not only can put pregnant lady at a
higher risk for a heart attack and stroke, but it can put her baby in danger as well.
Objective: To investigate the relation between serum level of homocysteine in women
with gestational diabetes and adverse pregnancy outcomes.
Methods: A case control study, carried out at Al-Yarmouk Teaching Hospital, Dept. of
Obstetrics and Gynecology and National Institute of Diabetic Center for from April 2014 to
the February 2015. Fifty pregnant women with gestational diabetes diagnosed by
abnormal oral glucose tolerance test, with gestational age between 28-40 weeks were
enrolled in this study, serum level of homocysteine was measured, and patients were
classified into two groups either normal or elevated homocysteine level with normal range
(5-12μmol ̸ L) and patient were followed till time of delivery, the serum level of
homocysteine was correlated with adverse pregnancy outcome.
Results: The mean level of homocysteine ± standard deviation for women with gestational
diabetes is (11.8 ±3.7). Elevated level of homocysteine was observed in 27 (54%) of
diabetic patients. The number of preterm delivery, stillbirth, placental abruption and
congenital malformation were significantly more frequent among those with elevated
homocysteine level as compared to those with normal level with p=0.038, p=0.02,
p=0.011, p=0.016, respectively. On the other hand, no significant association was found
between elevated homocysteine level and low birth weight, p=0.99.
Conclusion: Elevated homocysteine level in pregnancy with gestational diabetes
associated with adverse pregnancy outcomes.
Keywords: Gestational diabetes, Hyperhomocysteinemia, Fetal outcome