Abstract: Objective：To obtain the predictive value of serum homocysteine and lipid concentrations in first trimester for severe preeclampsia. Methods：This was a case-control study, selecting pregnant women underwent regular birth and delivery in our hospital from January 2016 to October 2016 as the research objects，74 severe preeclampsia and 75 uncomplicated singleton pregnancies were enrolled. The maternal serum Hcy, folic acid, VB12, TC, TG, LDL, HDL, Apo-A1, Apo-B and Lip a were tested in first trimester (11th to 12th week). Maternal characteristics and pregnancy outcome were collected for each individual woman. Logistic regression model was used to calculate adjusted odds ratios (OR) and 95% confidence intervals (CI). Receiver operating curve (ROC) analysis and the area under ROC curve (AUC) was used to indicate the best model for prediction. Results：There was significant differences in maternal age, BMI, gestational weeks and birth weight between two groups (P＜0.05). Women who subsequently developed severe preeclampsia had higher concentrations of Hcy, TG, and Apo-B than control subjects (P＜0.05). The folic acid concentrations were lower in women with severe preeclampsia than that in control subjects (P＜0.05). Logistic regression revealed age and Hcy were risk factors for severe preeclampsia. The OR was 1.11 and 2.04 respectively (P＜0.05). AUC of individual marker is among 0.600~0.693. Hcy was the highest（AUC=0.693, P＜0.001, 95%CI: 0.607~0.779）. AUC of multiple markers (TG+Apo-B+folic acid+Hcy+age+BMI) was 0.777 (P＜0.001, 95%CI: 0.704~0.851). Conclusions：Advanced age and first-trimester high homocysteine are the risk factors for severe preeclampsia. First-trimester Hcy and TG combined with maternal characteristics are promising markers in the risk assessment of severe preeclampsia.

Key words: Pre-eclampsia, Folic acid, Triglycerides, Severe preeclampsia, Homocysteine