Browse > Article

Maternal Plasma Homocysteine Levels and Pregnancy Outcomes  

안홍석 (성신여자대학교 식품영양학과)
Publication Information
Korean Journal of Community Nutrition / v.9, no.4, 2004 , pp. 483-490 More about this Journal
Abstract
Elevated maternal plasma homocysteine concentrations have been associated with adverse pregnancy outcomes, including birth defects, low birth weight, preeclampsia, spontaneous abortion, placental abruption, and other maternal or fetal complications. The purpose of this study was to assess the maternal plasma homocysteine level during pregnancy and to investigate the relationship between the plasma homocysteine concentrations and pregnancy outcomes. Venous blood samples were drawn from 82 pregnant women who were grouped with gestational age, 1st trimester (n = 26), 2nd trimester (n = 27) and 3rd trimester (n = 29). The concentration of plasma homocysteine was analyzed by HPLC, and pregnancy outcomes including gestational length, maternal weight gain, infant birth weight, and Apgar score were collected with the medical records of the pregnant women. The levels of plasma homocysteine of the pregnant women at the 1st, 2nd, and 3rd trimester were 5.7 $$\pm$ 3.7\mu㏖/L,\;5.6 \pm4.1\mu㏖/L\; and\; 7.0\pm 4.5\mu㏖/L$, respectively, which had not showed any significant difference. The result of this study showed that in case of the pregnant women at the 1st trimester, the maternal plasma homocysteine level of the pregnant women whose gestational length was less than 38 weeks was significantly high (p < 0.01) compared to that of the pregnants whose gestational length was more than 38 weeks. And also, the level of homocysteine of the pregnant women at the 2nd trimester was significantly low when the maternal weight gain was high (p < 0.05). These findings suggest that maternal plasma homocysteine level at early stage of gestation will be a predicter of gestational length and maternal weight gain.
Keywords
maternal plasma homocysteine; pregnancy outcomes; gestation length;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Goddijn-Wessel TAW, Wouters MGAJ, v.d, Molen EF, Spuijbroek MDEH, Steegers-Theunissen RPM,Bloom HJ, Boers GHJ, Eskes TKAB (1996): Hyperhomocysteinemia: a risk factor for placental abruption or infarction. Eur J Obstet Gynecol 66: 23-29   DOI   ScienceOn
2 Leeda M, Riyazi N, de Vries JIP, Jakobs C, van Geijn HP, Dekker GA (1998): Effects of folic acid and vitamin B6 supplementation on women with hyperhomocysteinemia and a history of preeclampsia or fetal growth restriction. Am J Obstet Gynecol 179: 135-139   DOI   ScienceOn
3 Malinow MR, Rajkovic A, Duell PB, Hess DL, Upson BM (1998): The relationship between maternal and neonatal umbilical cord plasma homocysteine suggests an potential role for maternal homocysteine in fetal metabolism. Am J Obstet Gynycol 178: 228-233   DOI   ScienceOn
4 Mill JL, McPartlin JM, Kirke PN (1995): Homocysteine metabolism in pregnancies complicated by neural tube defects. Lancet 345: 149-151   DOI   ScienceOn
5 Picciano MF (2000): Is homocysteine a biomarker for identifying women at risk of complicarions and adverse pregnancy outcomes? Am J Clin Nutr 71: 857-858
6 Schnyder G, Roffi M, Flammer Y, Pin R, Hess OM (2002): Effect of homocysteine-lowering therapy with folic acid, vitamin $B_12$ and vitamin $B_6$ on clinical outcome after percutaneous coronary intervention. JAMA 288: 973-979
7 Wouters MG, Boers GH, Bloom HJ, Trijbels FJ, Thomas CM, Borm GF, Steegers-Theunissen RP, Eskes TK (1993): Hyperhomocysteinemia: a risk factor in women with unexplained recurrent early pregnancy loss. Fertil Steril 60: 820-825   DOI   PUBMED
8 Cikot RJLM, Steegers-Theunissen RPM, Thomas CMG, de Boo TM, Merkus HMWM and Steegers EAP (2001): Longitudinal bitamin and homocysteine livels in normal pregnancy. Br J Nutr 85: 19-58
9 De Falco M, Scaramellino M, Pontillo M, Di Lieto A (2000): Homocysteinaernia during pregnancy and placental disease. Clin Exp Obst & Gyn 27(3-4): 188-190
10 De Vries JLP, Dekker GA, Huijgens PC, Jakobs C, Blomberg BME, Van Geijn HP (1997): Hyperhomocysteinemia and protein S deficiency in complicated pregnancies. Br J Obstet Gynecol 104: 1248-1254   DOI
11 Gerhard GT, Malinow MR, Deloughery TG, Jevans A, Sexton G (1999): Higher total homocysteine concentrations and lower folate concentrations in premenopausal black women than in premenopausal white women. Am J Clin Nutr 70: 252-260   DOI   PUBMED
12 Sauberlich HE (1990): Evaluation of folate nutrition in population groups, In 'Folic acid metabolism in health and disease' Picciano MF, Stokstad ELR and Gregry JF III, eds., Wiley-Liss. New York, p.221
13 Dudman NPB, Guo XW, Crooks R, Xie L, Silberberg JS (1996): Assay of plasma homocysteine: light sensitivity of the fluorescent 7benzo2 -oxa- 1, 3-diazole- 4-sulfonic acid derive, and use of appropriate calibrators. Clin Chem 42: 2028-2032
14 Selhub J (1999): Homocysteine metabolism. Ann Rev Nutr 19: 217-246
15 Vollset SE, Refsum H, Irgens LM, Emblem BM, Tverdal A, Gjessing HK, Monsen ALB, Ueland PM (2000): Plasma total homocysteine, pregnancy complications and adverse pregnancy outcomes: the Horland Homocysteine Study. Am J Clin Nutr 71: 962-968
16 den HeijerM (2003): Hyperhomocysteinaemia as a risk factor for venous thrombosis: an update of the current evidence. Clin Chem Lab Med 41(11): 1404-1407
17 Dierkes J, Kroesen M, Pietrizik K (1998): Folic acid and vitamin B6 supplementation and plasma homocysteine concentrations in healthy young women. Int J Vit Nutr Res 68: 98-103
18 Ahn HS, Jeong EY, Kim SY (2002): Studies on plasma homocysteine concentration and nutritional status of vitamin B6, B12 and folate in college women. Korean Nutr Society 35(1): 37-44
19 Anderson A, Hultberg B, Brattstrom L, Isaksson A (1992): Decreased serum homocysteine in pregnancy. Eur J Clin Chem Clin Biochem 30: 377-379
20 Ronnenberg AG, Goldman MB, Chen D, Aitken IW, Willett WC, Selgub J, Xu X (2002): Preconception homocysteine and b vitamin status and birth outcomes in Chinese women. Am J Clin Nutr 76: 1385-1391
21 Ubbink JB, Vermark WJ, Bissbort S (1991): Rapid high-performance liquid chromatography assay for total homocysteine levels in human serum. J Chromatogr 19: 565(1-2): 441-446
22 Institute of Medicine, Committe on Nutritional Status During Pregnancy and Lactation, Nutrition During Pregnancy. National Academy Press. Washington DC, 1990
23 Querce I, Bellet H, Hoffet M, Janbon C, Mares P, GRis JC (1998): A woman with five consecutive fetal death: case report and retrospective analysis of hyperhomocysteinemia prevalence in 100 consecutive women with recurrent miscarriages. Fertil Steril 69: 152-154   DOI   ScienceOn
24 Steegers-Theunissen RPM, Wathen NC, Eskes TKAB, van Raaij-Selten B, Chard T (1997): Maternal and fetal levels of methionine and homocysteine in early human pregnancy. Br J Obstet Gynecol 104: 20-24   DOI
25 Bondevik GT, Schneede J, Refsum H, Lie RT, Ulstein M, Kvale G (2001): Homocysteine and methylmalonic acid levels in pregnant Nepail women. Should cobalamin supplementation be considered? Eur J Clin Nutr 55: 856-865
26 Blom H (1996): Pathobiochemical implications of hyperhomocysteinemia. Fibrinosis 8: 86-87
27 Chambers SJ, Melnyk S, Pogribna M, Pogribny IP, Caudill MA (2002): Elevation in S-adenosylhomocysteine and DNA hypomethylation: potential epigenetic mechanism for homocysteine-related pathology. J Nutr 132: 2361S-2368S
28 Kim KN(2004): Effects of the interaction between the C677T 5, 10methylenetetra- hydrofolate reductase (MTHFR) polymorphism and serum B vitamins on maternal and fetal serum homocysteine levels, pregnancy outcomes, and postnatal growth measurements. Department of Food and Nutrition, Graduate School Ewha Womans University, Seoul, Korea
29 Brouwer lA, Dusseldorp M, Thomas CMG, Duran M (1999): Lowdose folic acid supplementation decrease plasma homocysteine concetrations: a randomizes trial. Am J Clin Nutr 69: 99-104   DOI
30 Harker LA, Harlan JM, Ross R (1983): Effect of sulfinpyrazone on homocysteine-induced endothelial cell injury and arterosclerosis in baboons. Circ Res 53(6): 731-739   DOI   PUBMED   ScienceOn
31 Ueland PM, Hustad S,Schneede J, Refsum H, Vollset SE (2002): Biological and clinical implications of the MTHFR C6777T polymorphism. Trends in Pharmacol Sci 22: 195-201
32 Dekket GA, De Vries JIP, Doelitzch PM (1995): Underyling disorders associated with severe early onset preeclrnpsia. Am J Obstet Gynecol 173: 1042-1048   DOI   ScienceOn
33 Aubard Y, Darodes N. Cantaloube M (2000): Hyperhomocysteinemia and pregnancy-review of our present understanding and therapeutic implications. Eur J Obstet Gynecol 93: 157-165
34 Burke G, Robinson K, Refsum H, Stuart B, Drumm J, Graham I (1992): Intrauterine growth retardation, perinatal death and maternal homocysteine levels. N Engl J Med 326: 69-70   PUBMED
35 Walker MC, Smith GN, Perkins SL, Keely EJ, Garner PR (1999): Changes in homocysteine levels during normal pregnancy. Am J Obstet Gynecol 180: 660-664   DOI   PUBMED   ScienceOn
36 Shin BS, Kim BY, Choi IJ, Jang WS, Cho HK, Lee KW, Song HS, Han JS, Kim SD (1998): Clinical usefulness of elevated plasma homocysteine levels in nulliparous pregnant women with predlampsia before their delivery as a risk factor. KSOG 41(10) : 2582-2587
37 De Koning ABL, Werstuk GH, Zhou J, Austin RC (2003): Hyperhomocysteinemia and its role in the development of atherosis. Clin Biochem 36: 431-441