Predictive value of homocysteine and blood lipid levels in late pregnancy for neonatal outcomes in women with hypertensive disorders of pregnancy.

OBJECTIVE

This study aimed to investigate the correlations of late-pregnancy homocysteine (Hcy) and lipid profiles with disease severity in hypertensive disorders of pregnancy (HDP) and evaluate their predictive value for subsequent neonatal outcomes.

METHODS

In total, 156 patients with HDP (61 with gestational hypertension [GH] and 95 with preeclampsia [PE]) were retrospectively analyzed. Clinical characteristics and laboratory parameters, including Hcy and blood lipid profiles, were collected. Logistic regression and subgroup analyses were used to identify the factors related to adverse neonatal outcomes, and receiver operating characteristic (ROC) curves were applied to assess their predictive performance.

RESULTS

Significant differences in systolic blood pressure, Hcy, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, total cholesterol (TC), triglyceride (TG), and albumin levels were observed between the GH and PE groups. Based on subgroup analyses and logistic regression data, increased Hcy, TC, and TG levels were independently associated with PE status. Additionally, higher late-pregnancy Hcy and TG levels and lower late-pregnancy HDL-C levels were significantly associated with an increased risk of adverse neonatal outcomes. The combined detection of Hcy, TG, and HDL-C demonstrated better predictive performance (the area under the ROC curve = 0.874, 95% CI: 0.812-0.922) than every single detection.

CONCLUSION

Elevated Hcy and TG levels and reduced HDL-C levels in the late pregnancy are significantly associated with disease severity and adverse neonatal outcomes in HDP. Combined assessment of these biomarkers may serve as a useful adjunct for predicting adverse neonatal outcomes.