vitamin-b-12 and Hypertension--Pregnancy-Induced

To analyse the pregnancy outcome by combining plasma homocysteine with uterine artery Doppler velocimetry at 11 to 14 weeks of gestation.. A prospective cohort study with 103 healthy pregnant women. Uterine artery Doppler velocimetry was performed at between 11 and 14 weeks of gestation. Abnormal blood flow was defined as average pulsatility index >1.5 and presence of unilateral or bilateral diastolic notch. Doppler scores were calculated by a modified scoring method of uterine artery flow velocity waveforms. Serum for measurement of homocysteine, vitamin B(12) and folate levels were collected when the ultrasonographic measurement was performed.. Pre-eclampsia developed in five, gestational hypertension in three, intrauterine growth restriction in two and preterm birth in eight patients. There was a significant difference between mean plasma homocysteine levels at different Doppler scores (p<0.001) and a weak positive correlation between Doppler scores and occurrence of pregnancy complications (r(s) = 0.232, p<0.05). Mean homocysteine level increased with increasing Doppler scores. Any uterine artery abnormality had a sensitivity of 88.9% in predicting obstetric complications. Addition of hyperhomocytenemia to Doppler scores did not change the sensitivity.. Maternal serum homocysteine level is increased in 11 to 14 weeks of gestation that is complicated with pre-eclampsia, gestational hypertension, intrauterine growth restriction and preterm birth. Addition of homocysteine determination to uterine artery Doppler in the first trimester does not add any advantage in predicting adverse perinatal outcome.

Topics: Adult; Biomarkers; Blood Flow Velocity; Female; Fetal Growth Retardation; Folic Acid; Gestational Age; Homocysteine; Humans; Hypertension, Pregnancy-Induced; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy Trimester, First; Premature Birth; Prognosis; Prospective Studies; Rheology; Ultrasonography, Prenatal; Uterine Artery; Vitamin B 12

Vitamin B12, folic acid, and docosahexaenoic acid levels are reported to be altered in women with preeclampsia. This study examined the effect of the above nutrients on brain neurotrophins and on the cognitive performance in adult offspring in a pregnancy-induced hypertension rat model. Pregnant dams were assigned to control, PIH-induced, and PIH-induced supplemented with vitamin B12, folate, omega-3 fatty acids, and the combined supplementation of vitamin B12, folate, and omega-3 fatty acids groups. In the PIH group, brain-derived neurotrophic factor levels (BDNF) were lower in the offspring at birth, while the adult offspring showed lower levels of docosahexaenoic acid (DHA) in the hippocampus and BDNF (p < 0.05 for both) in the cortex as compared to in the control group. They also demonstrated higher (p < 0.05) escape latency in the Morris water maze test and performed a greater (p < 0.01 for all) number of errors in the Radial eight-arm maze test. A combined supplementation of vitamin B12, folic acid, and omega-3 fatty acids improved the levels of LCPUFA, neurotrophins, and cognition. A maternal diet consisting of high levels of folate, vitamin B12, and DHA reduced the risk for cognitive disorders in the adult offspring in an animal model of pregnancy-induced hypertension.

Topics: Animals; Animals, Newborn; Brain-Derived Neurotrophic Factor; Cognition; Dietary Supplements; Fatty Acids, Omega-3; Female; Folic Acid; Hippocampus; Hypertension, Pregnancy-Induced; Male; Maze Learning; Pedigree; Pregnancy; Prenatal Exposure Delayed Effects; Rats; Rats, Wistar; Vitamin B 12

BACKGROUND This study investigated the relationship of serum homocysteine in early pregnancy with the risk of gestational hypertension (GH) and preeclampsia (PE) and with the severity of preeclampsia. MATERIAL AND METHODS In a retrospective cohort study, we identified 147 confirmed cases of preeclampsia (103 with mild PE and 44 with severe PE) and 147 confirmed cases of GH; 4418 women who remained normotensive and nonproteinuric throughout pregnancy served as controls. Maternal blood samples were collected at between 11 and 13 weeks of gestation to test serum concentrations of homocysteine (Hcy), folic acid, and VitB12. A logistic regression model was used to calculate adjusted odds ratios (aORs) and 95% confidence intervals (CIs). RESULTS Women who subsequently developed GH and PE were older and had higher body mass indexes (BMIs) than those in the control group. Compared with the control group, women who developed PE were less educated (P=0.031), and more of those who developed GH were primiparas (P=0.012). The serum levels of Hcy in severe PE were significantly higher than those in the control group (median: 8.50 μmol/L vs. 7.33 μmol/L, P<0.001). After logistic regression analyses for potential confounding factors, the adjusted odds ratios (aORs) of Hcy was 1.12 for severe PE (95% CI 1.06-1.20). The serum concentrations of folic acid and VitB12 in those with GH and PE were not significantly different from controls. CONCLUSIONS A high level of Hcy in the first trimester is an independent risk factor for severe PE, although it is not a useful marker for the subsequent development of GH and mild PE.

Topics: Adult; Biomarkers; Blood Pressure; Body Mass Index; Cohort Studies; Female; Folic Acid; Homocysteine; Humans; Hypertension, Pregnancy-Induced; Logistic Models; Odds Ratio; Pre-Eclampsia; Pregnancy; Pregnancy Trimester, First; Retrospective Studies; Risk Assessment; Risk Factors; Vitamin B 12

Preeclampsia is a disorder of pregnancy and is associated with inflammation and altered angiogenesis. The present study examines the effect of micronutrient and omega-3 fatty acid supplementation (individual, as well as combined) on genes involved in inflammation and angiogenesis, as well as global DNA methylation levels in a pregnancy induced hypertension (PIH) rat model.. Pregnant Wistar rats were randomly assigned to six dietary groups: control, PIH (Pregnancy induced hypertension) Induced; PIH Induced with micronutrient supplements with vitamin B. PIH induction increased the mRNA levels of the pro inflammatory cytokine IL-6 (p <0.01), while lowering the placental anti inflammatory cytokine IL-10 (p <0.05) at d20 of gestation. It also increased the expression of TNF-α (p <0.05) in the liver of 3 month old offspring. The combined supplementation of folic acid, vitamin B. Our data indicate that a combined supplementation of vitamin B

Topics: Animals; Biomarkers; Dietary Supplements; Fatty Acids, Omega-3; Female; Folic Acid; Hypertension, Pregnancy-Induced; Interleukin-10; Interleukin-6; Micronutrients; Placenta; Pregnancy; Random Allocation; Rats, Wistar; RNA, Messenger; Tumor Necrosis Factor-alpha; Vitamin B 12

Our recent study demonstrates the beneficial effect of a combined supplementation of vitamin B12, folic acid, and docosahexaenoic acid in reducing the severity of pregnancy induced hypertension (PIH). It is also known to be associated with angiogenic imbalance and inflammation. The current study examines whether the individual/combined supplementation of folic acid, vitamin B12 and omega-3 fatty acid during pregnancy can ameliorate the inflammatory markers and restore the angiogenic balance in a rat model of PIH.. There were total of six groups, control and five treatment groups: PIH Induced; PIH+vitamin B12; PIH+folic acid; PIH+Omega-3 fatty acids and PIH+combined micronutrient supplementation (vitamin B12+folic acid+omega-3 fatty acids). Hypertension during pregnancy was induced using L- Nitroarginine methylester (L-NAME; 50mg/kg body weight/day). Dams were dissected at d20 of gestation and placental tissues were collected for further analysis.. Animals from the PIH induced group demonstrated lower (p<0.01 for both) IL-10 and VEGF levels as compared to control. However, PIH induction did not alter the protein levels of eNOS, IL-6, Flt and mRNA levels of VEGF and VEGFR-1/ Flt-1. Individual micronutrient supplementation of vitamin B12 and folate did not offer benefit. In contrast individual omega-3 fatty acid as well as combined micronutrient supplementation showed IL-10 and VEGF levels comparable to that of control.. Omega 3 fatty acid supplementation plays a key role in reducing inflammation in pregnancy induced hypertension.

Topics: Animals; Dietary Supplements; Fatty Acids, Omega-3; Female; Folic Acid; Hypertension, Pregnancy-Induced; Interleukin-10; Pregnancy; Rats; Rats, Wistar; Vascular Endothelial Growth Factor A; Vitamin B 12

Reports indicate that during pregnancy hypertension is known to have long term adverse effects both in the mother and offspring. However, the effect of maternal micronutrient supplementation on this association of in utero exposure and risk of non-communicable diseases in the later life remains unclear. The present study examines the effect of maternal micronutrient and omega-3 fatty acid supplementation either individual or in combination on cardiometabolic risk factors both in the mother and offspring using an animal model of hypertension.. Pregnant Wistar rats were randomly assigned to the following groups; control, PIH (Pregnancy induced hypertention) Induced, PIH+vitamin B12, PIH+ folic acid, PIH+omega-3 fatty acids and PIH+combined smicronutrient supplementation (vitamin B12+folic acid + omega-3 fatty acids). The dams and their offspring were shifted to a control diet after delivery and the offspring continued on these diets till 3mo of age. Hypertension during pregnancy was induced using l-Nitroarginine methylester (50mg/kgbody weight/day).. Omega-3 fatty acid supplementation during pregnancy demonstrated lower levels (p<0.05) of plasma cholesterol while a combined supplementation of folic acid, vitamin B12 and omega 3 fatty acids demonstrated lower (p<0.05) triglyceride levels as compared to PIH induced dams. PIH induction increased (p<0.01) the triglyceride levels in the offspring at 3mo of age and maternal supplementation of either individual or combined micronutrients demonstrated lower (p<0.01) triglyceride levels.. Our findings have implications for planning intervention studies in women with pregnancy induced hypertension.

Topics: Animals; Blood Glucose; Cholesterol; Dietary Supplements; Disease Models, Animal; Fatty Acids, Omega-3; Female; Hypertension, Pregnancy-Induced; Pregnancy; Rats; Triglycerides; Vitamin B 12

Our earlier studies have highlighted that an altered one carbon metabolism (vitamin B12, folic acid, and docosahexaenoic acid) is associated with preeclampsia. Preeclampsia is also known to be associated with oxidative stress and inflammation. The current study examines whether maternal folic acid, vitamin B12 and omega-3 fatty acid supplementation given either individually or in combination can ameliorate the oxidative stress markers in a rat model of pregnancy induced hypertension (PIH).. Pregnant Wistar rats were assigned to control and five treatment groups: PIH; PIH + vitamin B12; PIH + folic acid; PIH + Omega-3 fatty acids and PIH + combined micronutrient supplementation (vitamin B12 + folic acid + omega-3 fatty acids). L-Nitroarginine methylester (L-NAME; 50 mg/kg body weight/day) was used to induce hypertension during pregnancy. Blood Pressure (BP) was recorded during pregnancy and dams were dissected at d20 of gestation.. Animals from the PIH group demonstrated higher (p<0.01 for both) systolic and diastolic BP; lower (p<0.01) pup weight; higher dam plasma homocysteine (p<0.05) and dam and offspring malondialdehyde (MDA) (p<0.01), lower (p<0.05) placental and offspring liver DHA and higher (p<0.01) tumor necrosis factor-alpha (TNF-ά) levels as compared to control. Individual micronutrient supplementation did not offer much benefit. In contrast, combined supplementation lowered systolic BP, homocysteine, MDA and placental TNF-ά levels in dams and liver MDA and protein carbonyl in the offspring as compared to PIH group.. Key constituents of one carbon cycle (folic acid, vitamin B12 and DHA) may play a role in reducing oxidative stress and inflammation in preeclampsia.

Topics: Animals; Biomarkers; Dietary Supplements; Drug Therapy, Combination; Fatty Acids, Omega-3; Female; Folic Acid; Hypertension, Pregnancy-Induced; Oxidative Stress; Pregnancy; Rats; Rats, Wistar; Vitamin B 12; Vitamins

The aim of this study was to investigate the changes in the peripheral blood of newborns of hypertensive mothers. The umbilical cord blood from newborns of 31 hypertensive mothers and 32 healthy mothers were examined. In all subjects, complete blood count, peripheral blood smear, reticulocyte count, vitamin B12, folate, ferritin levels and hemoglobin electrophoresis were performed. The subjects were followed up on for 1 year in terms of infections. RBC, hemoglobin, reticulocyte count and normoblast count were higher in the newborns of hypertensive mothers compared to the control group, and total leukocytes, neutrophil, lymphocyte, monocyte, eosinophil, and thrombocyte counts were lower. The number of neutropenic and thrombocytopenic subjects in newborns of hypertensive mothers was higher compared to the control group. On peripheral smears, dysplastic changes in neutrophils and erythrocytes were observed with a higher rate in newborns of hypertensive mothers compared to the control group. HbF levels were found to be higher in newborns of hypertensive mothers compared to the control group. During the follow-up period of 1 year, the number of infections in newborns of hypertensive mothers was found to be higher than the control group.. Newborns of hypertensive mothers should be carefully evaluated and monitored in terms of hematologic abnormalities. Complete blood counts and peripheral blood smears can be used as significant parameters for early diagnosis of possible complications.

Topics: Adult; Biomarkers; Blood Cell Count; Case-Control Studies; Erythrocyte Indices; Female; Ferritins; Fetal Blood; Follow-Up Studies; Hemoglobins; Humans; Hypertension, Pregnancy-Induced; Infant, Newborn; Logistic Models; Male; Pregnancy; Reticulocyte Count; Vitamin B 12

The aim was to investigate whether pregnancy-induced changes in total homocysteine (tHcy) are associated with folate and vitamin B12 nutritional status, genetic C677T polymorphism in the methylenetetrahydrofolate reductase (MTHFR) enzyme, and gestation outcome at a time when folic acid supplementation started to be recommended in the Spanish health system.. In total 154 pregnant women were recruited from among gynecologic patients of the Alcorcón Public Hospital Outpatient Clinic (Madrid, Spain). Blood tests were performed at weeks 15, 24, and 32 of pregnancy. Total Hcy, folate, and vitamin B12 serum fasting concentrations were measured using an IMx system. Genotype analyses were done by polymerase chain reaction/restriction fragment/length polymorphism analysis.. Folate and vitamin B12 serum concentrations decreased significantly (P < 0.01) through pregnancy and reached the lowest values in the third trimester. Serum tHcy concentrations were significantly (P < 0.01) lower in the second trimester but increased in the third trimester. Frequencies of MTHFR C667T genotype were CC (35.7%), CT (57.2%), and TT (7.1%). Total Hcy concentration was not statistically influenced by maternal genotype. Plasma folate was the single negative predictor of maternal tHcy in the first trimester of pregnancy; 11.1% of gestations resulted in intrauterine growth restriction, 7.9% in gestational diabetes mellitus, and 4.8% in gestational hypertension. No significant differences in serum folate, vitamin B12, or tHcy concentrations were found in complicated pregnancies and these were unrelated to MTHFR genotype.. Although tHcy seems to be physiologically low in this Spanish population and unrelated to folate and B12 nutritional status, C677T MTHFR genotype, and some pregnancy complications, we support the statement that appropriate folate concentration may be important throughout pregnancy to prevent abnormalities associated with altered status (e.g., neural tube defects). According to our study, supplementation with folic acid seems to achieve this purpose because diet alone may be insufficient. In addition, a poor vitamin B12 status, as measured by plasma levels, may indicate that supplementation of both vitamins is needed.

Topics: Adult; Diabetes, Gestational; Dietary Supplements; Female; Fetal Growth Retardation; Folic Acid; Genotype; Homocysteine; Humans; Hypertension, Pregnancy-Induced; Longitudinal Studies; Methylenetetrahydrofolate Reductase (NADPH2); Nutrition Policy; Polymorphism, Genetic; Pregnancy; Pregnancy Complications; Prevalence; Spain; Vitamin B 12