Hyperhomocysteinemia and Folate Deficiency in Preterm Premature Rupture of Membranes: A Hospital Based Case Control Study (India)

Abstract Aim: To understand the role of hyperhomocysteinemia in association with nutritional (folate and vitamin B12) factors involved in one carbon metabolic pathway in the causation of preterm premature rupture of membranes (PPROM). Methods: The case group (women presenting with PPROM) is compared with gestation matched pregnant women without PPROM or any bad obstetric history. Data on demographic, clinical and reproductive profile was obtained from all the women. Fasting blood sample (~5ml) was drawn followed by serum folate, vitamin B12 and plasma homocysteine level estimations. Results: Hyperhomocysteinemia and folate deficiency were found to be posing 8.46 and 2.9 fold increased risk for PPROM cases as compared to the gestation matched controls respectively. The differences were found to be statistically significant for both risk of hyperhomocysteinemia (p<0.0001) and folate deficiency (p=0.002) for preterm premature rupture of membranes. Conclusion: Hyperhomocysteinemia and folate deficiency are associated with PPROM. Keywords Hyperhomocysteinemia; folate deficiency; vitamin B12; preterm complications; rupture of membranes