Homocystine as a Diagnostic Marker for Preterm Labor.
Keywords:
Preterm labour, serum, homocystine, screening, testAbstract
Preterm labor poses significant risks to maternal, fetal, and neonatal health worldwide, with elevated homocysteine levels identified as a potential marker for its diagnosis. This case-control study conducted at the Department of Obstetrics and Gynecology, AL-Yarmouk Teaching Hospital, included 90 pregnant women divided into two groups: 40 with threatened preterm labor (group A) and 50 without signs of labor (group B). Serum homocysteine levels were measured using ELISA, revealing a significantly higher mean level in the preterm group (1.769±0.687 nmol/ml) compared to controls (0.810±0.261 nmol/ml) (p=0.001). At a cutoff point of 1.096 nmol/ml, homocysteine exhibited a sensitivity of 80%, specificity of 86.4%, positive predictive value of 84.3%, and accuracy of 83% for predicting preterm labor. This study underscores the potential of homocysteine measurement as a screening tool in conjunction with other tests to identify high-risk patients for preterm labor, thus aiding in timely interventions and improved maternal and neonatal outcomes.
References
Seshadri L, Arjun G. Essentials of Obstetrics. New Delhi: Wolters Kluwer (India) Pvt. Ltd.; 2015:508-521.
Al.-Badri HJA, Abdul-Hassan M. Serum total homocysteine level in Iraqi women with unexplained recurrent
miscarriage. JPMA The Journal of the Pakistan Medical Association. 2019.
Ali MA. Maternal and umbilical cord plasma homocysteine concentrations in preeclamptic pregnancy. Mustansiriya Medical Journal. 2014;13(1):June.
Cheng ZJ, Yang X, Wang H. Hyperhomocysteinemia and endothelial dysfunction. Curr Hypertens Rev. 2009;5(2):158-65.
Walker MC, Smith GN, Perkins SL, Keely EJ, Garner PR. Changes in homocysteine levels during normal pregnancy. American journal of obstetrics and gynecology. 1999;180(3):660-4.
Surya P, Sunil S, Mansee T. A Decade Review: Preterm Labor and Homocysteine. Research Journal of Biotechnology. 2021;16(2).
Boivin J, Bunting L, Collins JA, Nygren KG. International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility medical care. Human reproduction. 2007;22(6):1506-12.
Koullali B, Van Zijl MD, Kazemier BM, Oudijk MA, Mol BW, Pajkrt E, Ravelli AC. The association between parity and spontaneous preterm birth: a population based study. BMC pregnancy and childbirth. 2020;20(1):1-8.
Astolfi P, Zonta LA. Risks of preterm delivery and association with maternal age, birth order, and fetal gender. Human Reproduction. 1999;14(11):2891-4.
Goisis A, Remes H, Barclay K, Martikainen P, Myrskylä M. Advanced maternal age and the risk of low birth weight and preterm delivery: a within-family analysis using Finnish population registers. American journal of epidemiology. 2017;186(11):1219-26.
Murad AW, Abdelhamid AA. Maternal serum homocysteine and uterine artery pulsatility index as predictors of spontaneous preterm labor. Evidence Based Women's Health Journal. 2018;8(2):178-84.
Crane JM, Hutchens D. Use of transvaginal ultrasonography to predict preterm birth in women with a history of preterm birth. Ultrasound in Obstetrics and Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2008;32(5):640.
Kenny LC, Lavender T, McNamee R, O’Neill SM, Mills T, Khashan AS. Advanced maternal age and adverse pregnancy outcome: evidence from a large contemporary cohort. PloS one. 2013;8(2):e56583.
Granese R, Gitto E, D’Angelo G, Falsaperla R, Corsello G, Amadore D, Calagna G, Fazzolari I, Grasso R, Triolo O. Preterm birth: seven-year retrospective study in a single centre population. Italian journal of pediatrics. 2019;45(1):1.
Crane JM, Hutchens D. Use of transvaginal ultrasonography to predict preterm birth in women with a history of preterm birth. Ultrasound in Obstetrics and Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2008;32(5):640.
Buen M, Amaral E, Souza RT, Passini R, Lajos GJ, Tedesco RP, Nomura ML, Dias TZ, Rehder PM, Sousa MH, Cecatti JG. Maternal work and spontaneous preterm birth: a multicenter observational study in Brazil. Scientific reports. 2020;10(1):1-0.
Brown JS, Adera T, Masho SW. Previous abortion and the risk of low birth weight and preterm births. Journal of Epidemiology & Community Health. 2008;62(1):16-22.
Hardy G, Ghislain. Effect of Induced Abortions on Early Preterm Births and Adverse Perinatal Outcomes. J Obstet Gynaecol Can. 2013;35(2):138–143.
Healy M. Abortion and preterm births studied. Los Angeles Times.
Chamotra S, Pathania K, Verma SK, Chaudhary A. Predicting pregnancy outcomes from homocysteine level: an evidence from a North Indian study. Int J Reprod Contracept Obstet Gynecol. 2020;9:1498-502.
Dhobale M, Chavan P, Kulkarni A, Mehendale S, Pisal H, Joshi S. Reduced folate, increased vitamin B12 and homocysteine concentrations in women delivering preterm. Annals of Nutrition and Metabolism. 2012;61(1):7-14.
