Abstract
Background: The purpose of this study was to investigate the risk factors for elevating homocysteine during pregnancy and the relative effects on preeclampsia, so as to further understand whether Hcy had predictive value for PE.Method: This is a prospective study that only covers pregnant women with singleton who received regular prenatal care from July to September 2018 exclusively at IPMCH (N=1142). Homocysteine, folic acid and vitamin B12 were tested in the 1st trimester (10-14 weeks), 2nd trimester (24-28 weeks), and 3rd trimester (30-34 weeks), respectively, and MTHFR genes (rs1801133, rs1801131, rs17367504) were detected. Therefore, the analysis of this case includes the variation in Hcy levels during pregnancy, risk factors for elevating homocysteine and the risk factors on preeclampsia.Results: (1) Homocysteine was lowest in the 1st trimester. (2) Homocysteine was negatively correlated with folic acid (r=-0.17, p<0.001) and vitamin B12 (r=-0.15, p<0.001) in the same trimester. (3) Both of heterozygous CT (p=0.025, 95% CI 0.018, 0.275) and homozygous TT (p<0.001, 95% CI 0.185, 0.501) in MTHFR rs1801133 might be risk factors that caused an increase in Hcy. G-spot mutations in MTHFR rs17367504 might be a risk factor that caused a decline in homocysteine. (4) Homocysteine in the 3rd trimester might be significantly correlated with increasing risk of preeclampsia (OR = 1.2, 95% CI 1.01,1.42), particularly early-onset preeclampsia (OR = 3.63, 95% CI 1.71,7.71) and severe preeclampsia (OR = 3.63, 95% CI 1.71,7.71).Conclusions: The variation in homocysteine level in the third trimester might be associated with preeclampsia, especially early-onset preeclampsia and severe preeclampsia, and MTHFR, folic acid and vitamin B12 might be the three critical factors responsible for the changing homocysteine levels during pregnancy.
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