Association of Serum Homocysteine Level with Unexplained Recurrent Pregnancy Loss: A Case-Control Study

Author(s): Dr. Masuda Sultana, Prof. Dr. Nahreen Akhtar, Dr. Mousumi Saha, Dr. Nowshafreen Chowdhury, Dr. Parul Akhter, Prof. Dr. Firoza Begum

Background:

Recurrent pregnancy loss (RPL) is a very stressful and painful experience for the couple. Recurrent pregnancy loss without apparent causative factor which may be identified in about 50% of cases known as unexplained recurrent pregnancy loss (RPL). Hyperhomocysteinaemia is considered a major risk factor for this problem which is related either to a hereditary defect within the methionine-homocysteine pathway or it might be acquired as a result of deficiencies of vitamin B12 and B9.

Aim of the study:

The aim of the study was to evaluate the association of serum homocysteine level with unexplained recurrent pregnancy loss.

Methods:

This case-control study was conducted in the outpatient department of Feto-maternal Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh during the period from May 2020 to April 2021. According to inclusion and exclusion criteria, 34 patients with unexplained recurrent pregnancy loss (RPL) and 34 age and BMI-matched control were selected from OPD during the one-year study period. A 3ml blood sample was collected from the antecubital vein of all 68 participants in a plain test tube and was sent to the Biochemistry Department of BSMMU to assess the serum homocysteine level using direct chemiluminescent technology by the Atellica TM IM analyzer. The results were noted in the questionnaire and the data were analyzed by using SPSS software.

Results:

In this study, serum homocysteine levels of the 68 participants of both the case and control groups were measured and analyzed. We found hyperhomocysteinemia among 5.9% of patients in the case group as the abnormal homocysteine level. The mean homocysteine level of case group patients was 8.15±8.11 (μmol/L) which was found as 6.23±1.47 (μmol/L) in the control group. But statistically, we did not find any significant difference between the groups regarding the homocysteine level; the p-value was found as 0.787.

Conclusion:

Serum homocysteine level has no significant association with unexplained recurrent pregnancy loss. Even, no significant difference was found when serum homocysteine levels were compared with the control in 1st, 2nd and 3rd-trimester pregnancy loss.