Multigene Screening of B-Vitamin Metabolism Pathways in Hypertensive Disorders of Pregnancy: Toward Precision Prenatal Care.

Hypertensive disorders of pregnancy (HDP) are among the most common and serious complications of pregnancy, exerting substantial effects on both maternal and fetal health. B vitamins particularly folate, vitamin B6, and vitamin B12 are essential to multiple metabolic pathways, most notably homocysteine metabolism, which is closely associated with vascular function and blood pressure regulation. Although understanding of HDP pathophysiology has advanced, early prediction and personalized management remain difficult because of the complex interplay between genetic and environmental factors. Recent progress in multigene screening technologies has offered new insights into how genetic polymorphisms involved in B vitamin metabolism may contribute to HDP risk. This review synthesizes current evidence on the relationships between B vitamin-related gene variants and HDP, with a focus on the potential of multigene screening for early risk stratification, targeted nutritional intervention, and individualized clinical management. Integrating genetic screening into routine prenatal care may improve prevention and treatment outcomes by enabling care strategies tailored to genetic susceptibility. This strategy may help resolve the inconsistent results of B‑vitamin supplementation trials by enabling genotype‑targeted care. Overall, this review highlights the promise of B vitamin multigene screening as a clinical tool for advancing precision medicine approaches to hypertensive disorders of pregnancy and ultimately improving maternal and fetal health.