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Hyperhomocysteinemia: a risk factor in women with unexplained recurrent early pregnancy loss
M G Wouters1, G H Boers, H J Blom
1Department of Obstetrics and Gynecology, University Hospital Nijmegen, St Radboud, The Netherlands.
Objective:
To establish the prevalence of hyperhomocysteinemia in women with unexplained recurrent early pregnancy loss.
Design:
In a patient-control study, the methionine-homocysteine metabolism was investigated by a standardized oral methionine-loading test.
Setting:
Gynecologic outpatient department of university hospital.
Patients:
One-hundred and two women who had been referred to the hospital because they suffered from at least two consecutive unexplained spontaneous abortions (study group) as well as 41 controls who were recruited by public advertisement were selected.
Interventions:
Blood samples were collected just before and 6 hours after oral methionine administration to determine plasma total homocysteine concentrations.
Main Outcome Measure:
Plasma total homocysteine concentrations 6 hours after methionine loading. Hyperhomocysteinemia was defined as total homocysteine concentration at 6 hours exceeding the 97.5 percentile level of the controls.
Results:
Hyperhomocysteinemia was diagnosed in 21 women of the study group (21%). In the parous women of the study group, the prevalence of hyperhomocysteinemia was more than two times greater compared with the nulliparous subjects (33% and 14%, respectively).
Conclusion:
Hyperhomocysteinemia is a risk factor in women with unexplained recurrent early pregnancy loss.