Literature DB >> 22489763

Homocysteine and folate concentrations in early pregnancy and the risk of adverse pregnancy outcomes: the Generation R Study.

N E Bergen1, V W V Jaddoe, S Timmermans, A Hofman, J Lindemans, H Russcher, H Raat, R P M Steegers-Theunissen, E A P Steegers.   

Abstract

OBJECTIVE: To investigate associations between early pregnancy homocysteine, folate and vitamin B12 concentrations and placental weight, birthweight and adverse pregnancy outcomes.
DESIGN: Population-based birth cohort study.
SETTING: Rotterdam, the Netherlands. POPULATION: Cohort of 5805 pregnant women.
METHODS: To analyse homocysteine, folate and vitamin B12 concentrations, blood was drawn in early pregnancy. These concentrations were divided into quintiles. Information on birth outcomes was retrieved from medical records. Multivariate regression analyses were used. MAIN OUTCOME MEASURES: Placental weight, birthweight, small for gestational age at birth (SGA) (<5th centile), prematurity and pre-eclampsia.
RESULTS: High homocysteine concentrations (highest quintile) were associated with lower placental weight (difference 30 g; P < 0.001) and birthweight (difference 110 g; P < 0.001), and increased risk of SGA [odds ratio (OR) 1.7; P = 0.006] compared with lowest quintile (reference). Low folate concentrations (lowest quintile) were associated with lower placental weight (difference 26 g; P = 0.001) and birthweight (difference 125 g; P < 0.001), and increased risks of SGA (OR 1.9; P = 0.002), prematurity (OR 2.2; P = 0.002) and pre-eclampsia (OR 2.1; P = 0.04) compared with highest quintile (reference). The risk of developing SGA and pre-eclampsia was substantially higher in women who had higher homocysteine and lower folate concentrations. No associations were found with vitamin B12.
CONCLUSIONS: Higher homocysteine and lower folate concentrations in early pregnancy are associated with lower placental weight and birthweight, and higher risk of adverse pregnancy outcomes. These findings suggest that high homocysteine and low folate concentrations in early pregnancy may adversely influence placentation and subsequently affect the success of pregnancy and birth outcomes.
© 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

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Year:  2012        PMID: 22489763     DOI: 10.1111/j.1471-0528.2012.03321.x

Source DB:  PubMed          Journal:  BJOG        ISSN: 1470-0328            Impact factor:   6.531


  78 in total

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