ArticleCureus2026
Maternal Serum Homocysteine as a Severity-Linked Biomarker Across the Spectrum of Hypertensive Disorders of Pregnancy: A Prospective Observational Study.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHypertensive disorders of pregnancy (HDP) remain a leading cause of maternal and perinatal morbidity worldwide. Endothelial dysfunction is central to the pathogenesis of preeclampsia, and serum homocysteine, a pro-oxidant amino acid, has been implicated in vascular injury and placental insufficiency.
methodsThis prospective observational study included 200 pregnant women beyond 20 weeks of gestation, stratified into four equal groups: normotensive controls, non-severe preeclampsia, severe preeclampsia, and eclampsia (n = 50 each). Serum homocysteine levels were measured at admission prior to therapeutic intervention. Clinical and demographic variables were recorded. Continuous variables were analysed using one-way ANOVA and categorical variables using the χ² test, with statistical significance set at p < 0.05.
resultsMaternal serum homocysteine levels demonstrated a significant and progressive increase with disease severity, rising from 12.04 ± 2.34 µmol/L in normotensive women to 26.74 ± 6.58 µmol/L in eclampsia (p = 0.0251). Primigravidity was more common in severe disease groups (p = 0.0375), and maternal body mass index increased with severity (p = 0.0461). Caesarean section rates were significantly higher in severe preeclampsia (70%) and eclampsia (80%) compared with controls (p < 0.001). Blood pressure normalised across all groups at 12 weeks postpartum.
conclusionsMaternal serum homocysteine is strongly associated with both the presence and severity of HDP. Its progressive elevation across the disease spectrum highlights its potential role as a clinically useful biomarker for early risk stratification and management. Integration of homocysteine assessment into routine obstetric care may enhance the prediction of severe disease and improve maternal outcomes.
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