The Role of Hyperhomocystinemia in Recurrent Pregnancy Loss

Abstract

Miscarriage is the most common type of pregnancy loss and about 15-25% of recognized pregnancies will end in a miscarriage) and about  5% of women will experience recurrent miscarriage. To assess the prevalence of hyperhomocystinemia in pregnant patients with unexplained recurrent pregnancy loss and to evaluate the association of hyperhomocystinemia with adverse pregnancy outcome as, preterm labour , pre-eclampsia ,placental abruption and intrauterine growth restriction. This was a  case- control study conducted in the Obstetrics and Gynecology Department  at  Al-Diwaniyah Maternity and Pediatrics Teaching Hospital,  Iraq, from the period of  February 2019 - December 2019 as 37 patients with unexplained  recurrent pregnancy loss(RPL) with no live birth were enrolled as a( study group) and 38 patients with Recurrent pregnancy loss with at least one successful pregnancy were enrolled  as a (control group). All patients aged 18-40 years with gestational age 10-14 weeks to aiiow abnormal pregnancies to passed spontaneousely ,and fasting plasma homocystin was measured  for all patients and they were followed during pregnancy for the development of any adverse pregnancy  complications.       Fasting serum homocystin level was significantly higher among the study group patients (48.6%) , compared to (26.3%) of the control group patients (p≤0.05). Fasting homocysytin level mean ∓ SD among the study and control group was( 10.08∓ 6.28 µ mol/dL),( 6.84∓ 4.89 µ mol/dL), respectively, with a (p≤0.05).Higher complications rate was among the study group as 18 patients(48.6%) develop adverse pregnancy outcome , while in the control group only 10 patients (26.3%) had developed adverse pregnancy outcome(p≤0.05) as more complications rate as  Intra uterine grouth restrictio, Pregnancy induced hyper tention, Pre-eclampsia and spontaneous abortion  were among the study group (18.9%, 10.8%, 2.7% and 5.4%) compared to (10.5%, 5.3%, 0.0%, and 5.3%) among the control group, respectively (p>0.05).