Annual Meeting Abstract Open Access

Homocysteine – A Novel Diagnostic Serum Biomarker for adverse pregnancy outcome

Abstract

1. Abstract: The primary aim of good antenatal care is the identification and management of high-risk pregnancies and their complications. Any disturbances in placentation, increases the risk of early miscarriage and other complications like pre-eclampsia, abruptio placenta, intra-uterine fetal death (IUD) or intra-uterine growth restriction (IUGR). This study primarily studies the association of maternal serum biomarker- Homocysteine for the early diagnosis of adverse pregnancy outcome. Homocysteine is a thiol-containing amino acid produced by the intracellular demethylation of methionine. Increased levels of maternal serum homocysteine levels indicate an abnormality in the placental microvasculature attributable to placental insufficiency. Method This was a prospective cohort study involving 100 singleton gestations in Department of Obstetrics and Gynaecology, in Amrita Institute of Medical Sciences, Kochi, a tertiary care centre in southern India from July 2016 and September 2018. Serum Homocysteine estimation (tHcy) was done between 18-28 weeks of gestation. Their medical and obstetric history was obtained and participants were followed up until delivery. Statistical analysis done with SPSS, Chi Square test and diagnostic measures used. Results Out of the 100 samples, it was found that during the course of pregnancy, 15% were subject to hypertensive disorder at some point while 7 % had fetal growth restriction (FGR) and 7% had preterm birth. Statistically significant results were obtained when elevated tHcy was linked to the development of: - Hypertensive disorders (p Value of 0.001) with a sensitivity of 27% and specificity-99%. - FGR (Fetal growth restriction) (p Value of 0.039) with sensitivity and specificity of 29% and 98% respectively. - Preterm birth (p Value of 0.001) - Low APGAR score at birth (p Value- 0.02) but low sensitivity of 3.2% Conclusion Findings from this study certainly have potential clinical implications for the early diagnosis and management of high-risk pregnancies

Pooja Ramesh

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