Oluwole A A, Nwogu C M, Sekumade A, Ajepe A, Okunade K S
Department of Obstetrics and Gynaecology, College of Medicine, University of Lagos/ Lagos University Teaching Hospital LUTH, Idi-Araba, Lagos, Nigeria.
Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital LUTH, Idi-Araba, Lagos, Nigeria.
West Afr J Med. 2020 Jan-Mar;37(1):246-252.
Clinical evidence had suggested that hyperhomocysteinaemia features in hypertensive disorders of pregnancy. However, there is still conflicting evidence on the extent to which elevated maternal homocysteine contributes to this deadly complication of pregnancy.
This study investigated the impact of elevated maternal homocysteine levels in early pregnancy on preeclampsia and its severity among Nigerian women in Lagos.
This was a prospective cohort study conducted at the Lagos University Teaching Hospital. Participants were enrolled in the first trimester of pregnancy following which their sociodemographic data were obtained by interview. Venous blood samples were collected for measurement of homocysteine concentration using the ELISA method. Data on the occurrence of preeclampsia was obtained from the delivery records. Binary logistic regression model was used to study the effects of the major baseline characteristics on the development of preeclampsia.
The final analysis included 167 patients; hyperhomocysteinaemia was recorded in 24 (24.6%) patients. Women with hyperhomocysteinaemia had no statistically significant risk of developing preeclampsia or severe preeclampsia, compared with women with a normal homocysteine concentration.
The prevalence of hyperhomocysteinaemia in the study was relatively low. The absence of a significant association between maternal hyperhomocysteinaemia and preeclampsia reported in this study could create room for the conduct of a more robust, adequately powered longitudinal research needed to answer some of the major reservations that remain from the present study.
临床证据表明,高同型半胱氨酸血症是妊娠高血压疾病的特征之一。然而,关于母体同型半胱氨酸升高在多大程度上导致这种致命的妊娠并发症,仍存在相互矛盾的证据。
本研究调查了妊娠早期母体同型半胱氨酸水平升高对拉各斯尼日利亚女性先兆子痫及其严重程度的影响。
这是一项在拉各斯大学教学医院进行的前瞻性队列研究。参与者在妊娠早期入组,随后通过访谈获取其社会人口统计学数据。采集静脉血样,采用酶联免疫吸附测定(ELISA)法测量同型半胱氨酸浓度。先兆子痫发生情况的数据从分娩记录中获取。采用二元逻辑回归模型研究主要基线特征对先兆子痫发生的影响。
最终分析纳入了167例患者;24例(24.6%)患者记录有高同型半胱氨酸血症。与同型半胱氨酸浓度正常的女性相比,高同型半胱氨酸血症女性发生先兆子痫或重度先兆子痫的风险无统计学意义。
本研究中高同型半胱氨酸血症的患病率相对较低。本研究报告的母体高同型半胱氨酸血症与先兆子痫之间无显著关联,这可能为开展更有力、有足够样本量的纵向研究创造空间,以解答本研究中仍存在的一些主要疑问。