Analysis On Correlation Between Homocysteine,Folic Acid And Vitamin B12 And Hypertensive Disorders Of Pregnancy

Objective: Analysis of the relationship between serum homocysteine(Hcy),folic acid(FA),Vitamin B12(Vit B12)and hypertensive disorders of pregnancy(HDP),and to explore the clinical significance of Hcy,FA and Vit B12 on the incidence,severity and pregnancy outcome of HDP,and provide experimental theoretical basis for clinical assistance in diagnosis,prevention of disease development and improvement of maternal and infant outcomes.Method: A total of 368 cases of HDP patients were collected from the obstetrics clinic of Hebei Medical University Second Hospital from July 2018 to October 2019 and were delivered in hospital,including 93 cases of gestational hypertension and 186 cases of preeclampsia,67 cases of chronic hypertension with superimposed preeclampsia,22 cases of pregnancy combined with chronic hypertension group.According to the degree of illness,the preeclampsia group was further divided into 53 cases in the preeclampsia group and 133 cases in the severe preeclampsia group;the severe preeclampsia group was further divided into 76 cases in the early onset group and 57 cases in the late onset group according to the onset of pregnancy.At the same time,120 normal pregnant women in the third trimester were selected as the control group,and their clinical data were retrospectively analyzed.Result:1.Serum Hcy level in the case group was higher than that in the control group(P <0.05).The preeclampsia group was higher than the gestational hypertension group(P <0.05),the chronic hypertension with superimposed preeclampsia group was higher than the pregnancy combined with chronic hypertension group(P <0.05).2.Serum levels of FA and Vit B12 in the case group were lower than those in the control group(P <0.05).The preeclampsia group was lower than the gestational hypertension group(P <0.05),the chronic hypertension with superimposed preeclampsia group was lower than the pregnancy combined with chronic hypertension group(P <0.05).3.Serum Hcy levels in the severe preeclampsia group were higher than those in the preeclampsia group,and the early onset group was higher than the late onset group(P <0.05).The levels of serum FA and Vit B12 in the severe preeclampsia group were lower than those in the preeclampsia group,and the early-onset group was lower than the late-onset group(P <0.05).4.The preterm birth rate,cesarean section rate,incidence of placental abruption,stillbirth rate,fetal growth restriction rate,intrauterine distress rate,and neonatal admission rate of NICU(neonatal intensive care unit)were higher in the case group than in the control group(P <0.05).There were no significant differences between the two groups in the induction rate,the incidence of HELLP syndrome(hemolysis,elevated liver enzymes,and low platelet count syndrome),the postpartum hemorrhage rate,and the rate of neonatal asphyxia(P >0.05).The premature birth rate and the rate of neonatal enrollment of NICU in the preeclampsia group were higher than those in the gestational hypertension group(P <0.05);the preterm birth rate,fetal growth restriction rate,and neonatal admission to the NICU in the chronic hypertension with superimposed preeclampsia group was higher than those in the the pregnancy combined with chronic hypertension group(P <0.05).5.The preterm birth rate,induction rate,stillbirth rate,fetal growth restriction rate,incidence of intrauterine distress,and neonatal admission rate of NICU in the severe preeclampsia group were higher than those in the preeclampsia group,and higher in the early onset group than in the late onset group(P <0.05);the three groups had no significant differences in cesarean section rate,placental abruption rate,incidence of HELLP syndrome,postpartum hemorrhage rate,and neonatal asphyxia rate(P >0.05).6.Serum Hcy and FA levels,Hcy and Vit B12 levels were negatively correlated.Conclusions:1.Serum Hcy,FA and Vit B12 levels are related to the onset of hypertension disorders of pregnancy.Abnormally increased levels of Hcy accompanied by decreased levels of FA and Vit B12 can lead to the development of gestational hypertension and preeclampsia,which can also lead to pregnancy with chronic hypertension developing into chronic hypertension with superimposed preeclampsia.2.Serum Hcy level in patients with HDP is positively correlated with the degree of disease,and negatively correlated with the onset of gestational week;serum FA and Vit B12 levels are negatively correlated with the degree of disease,and positively correlated with the onset of gestational week.3.Abnormally increased levels of Hcy accompanied by decreased levels of FA and Vit B12 can lead to an increased incidence of adverse pregnancy outcomes.Strengthening the monitoring of Hcy,FA and Vit B12 in pregnant women,especially pregnancy with chronic hypertension,is of great clinical significance for understanding the disease development and improving the adverse pregnancy outcome.