Investigation of the relationship between the serum tetrahydrobiopterin and folic acid levels with each other and with preeclampsia in the second and third trimesters

Aim: This study aims to investigate the relationship between serum tetrahydrobiopterin (BH4) and folic acid levels in pregnant women during the second and third trimesters and the development of preeclampsia. The study is based on the hypothesis that BH4 and folic acid levels may be potential biomarkers for predicting the risk of preeclampsia. Method: This randomized controlled study was conducted at Van Yüzüncü Yıl University Dursun Odabaşı Medical Center between June 2022 and February 2024, involving a total of 160 pregnant women, both with and without preeclampsia (PE). Participants were initially divided into PE and control groups, and then further categorized based on their folic acid usage. This resulted in four distinct groups: non PE without folic acid, non-PE with folic acid, PE without folic acid, and PE with folic acid. Demographic characteristics (age, gestational age, gravida, BMI) and various laboratory parameters (blood pressure, hemoglobin, PLT, liver enzymes, creatinine, homocysteine, albumin, total protein, urinary protein, BH4, biopterin, NO, folate, vitamin B12) were recorded for each participant and compared among the groups. Results: The results indicated significantly higher blood pressure, lower albumin and total protein levels, and higher urinary protein levels in the PE group compared to the control group. Additionally, BH4 levels were significantly lower in the PE group compared to the control group. Regarding folic acid usage, the group without folic acid supplementation exhibited significantly lower folate and hemoglobin levels compared to the group with folic acid supplementation. Conclusion: This study has demonstrated a significant association between serum BH4 and folic acid levels and the development of preeclampsia. Lower BH4 levels were observed in preeclamptic pregnant women, while folic acid supplementation was found to positively influence folate and hemoglobin levels. Keywords: :Preeclampsia, tetrahidrobiopterin, folic asid