Objective:Maternal plasma homocysteine decreases in normal pregnancy and is significantly increased in preeclampsia. The goal of this study was to investigate the role of the maternal kidney in the changes of plasma homocysteine during normal pregnancy and preeclampsia.
Methods:Plasma and 24-hour urine samples were collected in the same women before, during (first, second, and third trimesters), and after normal pregnancy; and in a separate cross-sectional study of normal pregnant, preeclamptic and nonpregnant women and homocysteine concentrations were measured.
Results:Longitudinally, maternal plasma homocysteine decreased significantly by the first trimester compared with prepregnancy and postpartum levels (5.6 ± 1.8 versus 6.8 ± 0.5 and 7.4 ± 0.4 μM, respectively, P < .05 by analysis of variance) and paralleled a significant increase in the renal clearance of homocysteine (2.9 ± 0.4 versus 1.8 ± 0.2 and 1.6 ± 0.2 L/24 hours, respectively, < < 001). In addition plasma homocysteine was significantly elevated in preeclampsia compared with normal pregnancy (4.4 ± 0.6 versus 3.2 ± 0.2 μM, P < .04); however, renal clearance was not different (1.2 ± 0.1 versus 1.0 ± 0.1 L/24 hours, P = .55).
Conclusion:Increases in renal clearance contribute to the decrease in plasma homocysteine during normal pregnancy. However, changes in renal handling do not appear to contribute to the increase in plasma homocysteine in preeclampsia.
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