vitamin-b-12 and Pre-Eclampsia

Some evidence has shown an association between maternal vitamin B12 levels and the development of preeclampsia in pregnant women, but the relationship between preeclampsia and vitamin B12 is not clear.. The aim of this systematic review was to compare serum vitamin B12 levels in women with preeclampsia with those in normotensive pregnant women.. The PubMed/MEDLINE, Scopus, and Web of Science databases were searched up to August 2019, along with the reference lists of included articles.. The literature was searched for observational studies that investigated vitamin B12 levels in women with preeclampsia.. Data were extracted independently by 2 authors. Data were pooled using a random-effects model.. Vitamin B12 levels in women with preeclampsia were significantly lower than those in healthy women (mean, -15.24 pg/mL; 95%CI, -27.52 to -2.954; P < 0.015), but heterogeneity between studies was high (I2 = 97.8%; P = 0.0103). Subgroup analyses based on folic acid supplementation, homocysteine concentrations, and gestational age at the time of sampling for vitamin B12 assessment did not identify the sources of heterogeneity.. Women with preeclampsia had significantly lower vitamin B12 concentrations than normotensive pregnant women.

Topics: Adult; Female; Folic Acid; Homocysteine; Humans; Observational Studies as Topic; Pre-Eclampsia; Pregnancy; Vitamin B 12; Young Adult

Homocysteine (Hct) is a substance produced in the metabolism of methionine. It is an essential type of amino acid gained from the daily diet. Methylenetetrahydrofolate reductase (MTHFR) gene mutation is related to elevated total homocysteine (tHct) expressions, in particular, among women with low folate intake. Hyperhomocysteinemia (HHct) is caused by numerous factors, such as genetic defects, lack of folic acid, vitamin B

Topics: Abortion, Habitual; Aging; Birth Weight; Diabetes, Gestational; Dietary Supplements; Female; Fetal Growth Retardation; Folic Acid; Homocysteine; Humans; Hyperhomocysteinemia; Placenta; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B 6; Vitamin B 6 Deficiency

The water-soluble vitamins B6, B12 and C play important roles in maternal health as well as fetal development and physiology during gestation. This systematic review evaluates the risks and benefits of interventions with vitamins B6, B12 and C during pregnancy on maternal, neonatal and child health and nutrition outcomes. Relevant publications were identified by searching PubMed, Popline and Web of Science databases. Meta-analyses were conducted for outcomes where results from at least three controlled trials were available. Potential benefits of vitamin B6 supplementation were reduction in nausea and vomiting, improvement in dental health, and treatment of some cases of anaemia. In meta-analysis based on three small studies, vitamin B6 supplementation had a significant positive effect on birthweight (d = 217 g [95% confidence interval (CI) 130, 304]). Interventions with vitamin C alone or combined with vitamin E did not systematically reduce the incidence of pre-eclampsia, premature rupture of membranes, or other adverse pregnancy outcomes. In meta-analyses, vitamins C and E increased the risk of pregnancy-related hypertension (relative risk 1.10 [95% CI 1.02, 1.19]). Effects of vitamin B6 or C intervention on other neonatal outcomes, including preterm birth, low birthweight, and perinatal morbidity and mortality, were not significant. Data on child health outcomes were lacking. Despite the prevalence of vitamin B12 deficiency amongst populations with limited intake of animal source foods, no intervention trials have evaluated vitamin B12 supplementation before or during pregnancy. In conclusion, existing evidence does not justify vitamin C supplementation during pregnancy. Additional studies are needed to confirm positive effects of vitamin B6 supplementation on infant birthweight and other outcomes. While vitamin B12 supplementation may reduce the incidence of neural tube defects in the offspring based on theoretical considerations, research is needed to support this hypothesis.

Topics: Ascorbic Acid; Ascorbic Acid Deficiency; Birth Weight; Child Welfare; Child, Preschool; Dietary Supplements; Female; Humans; Infant; Infant Nutritional Physiological Phenomena; Maternal Nutritional Physiological Phenomena; Maternal Welfare; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Randomized Controlled Trials as Topic; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B 6; Vitamin B 6 Deficiency

We conducted a systematic review to examine the hypothesized mechanism through which homocysteine could lead to preeclampsia.. We searched MEDLINE, EMBASE, BIOSIS, SciSearch, and bibliographies of primary and review articles, and we contacted experts.. Of the 25 relevant primary articles, 8 studies measured total serum homocysteine concentrations before the clinical onset of preeclampsia (1,876 women), whereas 17 measured it afterward (1,773 women). Meta-analytic techniques were used to examine consistency, strength, temporality, dose-response, and plausibility of the disease mechanisms implicating folate, vitamin B(6), vitamin B(12), genetic polymorphisms, oxidative stress, and endothelial dysfunction in the pathway linking hyperhomocysteinemia to preeclampsia.. Overall, there were higher serum homocysteine concentrations among pregnant women with preeclampsia than among those with uncomplicated pregnancies, but the results were heterogeneous (P = .12; I(2) = 38.8%). Among studies with temporality, the size of association was smaller than that among those without (weighted mean difference 0.68 mumol/L versus 3.36 mumol/L; P < .006). There was no dose-response relationship between homocysteine concentration and severity of preeclampsia. The mechanisms underlying hyperhomocysteinemia (folate and vitamin B(12) deficiency and genetic polymorphisms) were not found to be plausible, but markers of oxidative stress and endothelial dysfunction were higher in hyperhomocysteinemia.. Homocysteine concentrations are slightly increased in normotensive pregnancies that later develop preeclampsia and are considerably increased once preeclampsia is established. However, because of a lack of consistency in data, dose-response relationship, and biologic plausibility, the observed association cannot be considered causal from the current literature.

Topics: Adult; Age Factors; Biomarkers; Female; Folic Acid; Gestational Age; Homocysteine; Humans; Hyperhomocysteinemia; Incidence; Maternal Age; Parity; Pre-Eclampsia; Predictive Value of Tests; Pregnancy; Primary Prevention; Randomized Controlled Trials as Topic; Risk Assessment; Sensitivity and Specificity; Survival Rate; Vitamin B 12

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

Many studies have suggested that folate plays a role in preeclampsia (PE) risks, but few studies have assessed folate-related 1-carbon metabolism (OCM)-related nutrients with the risk of PE. We hypothesized that OCM-related nutrients are associated with PE. A 1:1 matched case-control study was conducted to explore the association between dietary OCM-related nutrients intake and the risk of PE in pregnant Chinese women. Four hundred and forty pairs of pregnant women with PE and hospital-based, healthy pregnant women, matched according to gestational week (±1 week) and age (±3 years), were recruited. Dietary intake was assessed using a validated 78-item semiquantitative food frequency questionnaire. Multivariate conditional logistic regression was used to estimate odds ratios (ORs) and 95% CIs. Restricted cubic splines were plotted to evaluate the dose-response relationship between dietary OCM-related nutrient intake and the risk of PE. Intake of folate, vitamin B

Topics: Case-Control Studies; Choline; Eating; Female; Folic Acid; Humans; Methionine; Nutrients; Pre-Eclampsia; Pregnancy; Pregnant Women; Pyridoxine; Racemethionine; Vitamin B 12; Vitamin B 6; Vitamins

The aim of this study was to determine the serum levels of folic acid, cobalamin, and indicators of energy metabolism during the peripartum period of ewes submitted to different diets and with or without pregnancy toxemia. Forty Santa Inês ewes were divided into three groups, a group of 20 animals fed only roughage-diet with low energy density (G1), a group of 10 ewes submitted to diet containing roughage and concentrate-diet with high energy density (G2), and a group of 10 ewes with diagnosis of pregnancy toxemia (PT) (G3). In the ewes of groups G1 and G2, blood samples were collected -30, -15, -7 days pre-partum, on the day of partum, and 7, 15, and 30 days postpartum; blood samples from G3 animals were collected during the veterinary clinic care. Significant variations were observed in the plasma concentration of glucose and serum folic acid, cobalamin, fructosamine, NEFA, and β-hydroxybutyrate in the groups fed diets with different energy levels, with and without PT (P < 0.05). A positive correlation of folic acid and cobalamin was observed with plasma glucose and serum NEFA concentrations, in addition to negative correlation of glucose with NEFA and β-hydroxybutyrate and positive correlation between the latter biomarkers of energy metabolism. The ewes diagnosed with PT showed higher levels of folic acid, NEFA, and β-hydroxybutyrate (P < 0.05). Ewes fed diet containing roughage and concentrate present higher serum levels of folic acid, cobalamin, and glucose, in the pre-partum period and in the lactation period. The results obtained contribute to better understanding of the application of blood concentration tests for folic acid and cobalamin in the energy metabolism and in PT in ewes.

Topics: 3-Hydroxybutyric Acid; Animals; Diet; Dietary Fiber; Energy Metabolism; Fatty Acids, Nonesterified; Female; Folic Acid; Glucose; Lactation; Peripartum Period; Pre-Eclampsia; Pregnancy; Sheep; Vitamin B 12

Hyperhomocysteinemia may be a risk factor for endothelial dysfunction. Folate and vitamin B12 regulate the homocysteine metabolic process. This study aimed to evaluate the associations between subsequent events of adverse pregnancy outcome and early variables of homocysteine, folate, and vitamin B12 in pregnant women.. This multicenter, retrospective, case-control study involved 563 pregnant women with adverse pregnancy outcome and 600 controls. Adverse pregnancy outcomes included one or more of the following events: preeclampsia, preterm birth, low birth weight, and stillbirth. The associations between subsequent events of adverse pregnancy outcome and early variables of homocysteine, folate, and vitamin B12; metabolic parameters; inflammatory markers; anthropometrics; and lifestyle habits at 11-12 weeks of gestation were analyzed using the logistic regression model.. Compared to the lower quartile homocysteine concentrations, the upper quartile homocysteine concentrations were associated with preeclampsia, preterm birth and low birth weight. On the contrary, the lower quartile folate concentrations were associated with preeclampsia, preterm birth and low birth weight compared with the upper quartile folate concentrations. The incidence of adverse pregnancy outcome increased progressively from the first to fourth homocysteine quartiles but decreased progressively from the first to fourth folate quartiles. After adjusting for confounding factors, multivariate logistic regression analysis showed that besides systolic blood pressure, diastolic blood pressure, body mass index and age, homocysteine (IV vs I quartile, aOR 5.89, 95% CI 4.08-8.51, P < 0.001), folate (IV vs I quartile, aOR 0.35, 95% CI 0.25-0.50, P < 0.001), folate supplementation (yes vs no, aOR 0.55, 95% CI 0.35-0.86, P = 0.010) during early pregnancy were independently associated with subsequent events of adverse pregnancy outcome, and vitamin B12 was rejected. Of these, the homocysteine revealed the highest odds ratio in all risk variables, and folate showed the lowest odds ratio in all protective variables.. Higher homocysteine concentration and lower folate level during early pregnancy were associated with adverse pregnancy outcome. However, no association was found between vitamin B12 and adverse pregnancy outcome. Supplementation with folate in early pregnancy may reduce adverse pregnancy outcome.

Topics: Adult; Case-Control Studies; China; Female; Folic Acid; Homocysteine; Humans; Infant, Low Birth Weight; Pre-Eclampsia; Pregnancy; Pregnancy Outcome; Pregnancy Trimester, First; Premature Birth; Retrospective Studies; Risk Factors; Vitamin B 12

Micronutrients like vitamin B

Topics: Adolescent; Adult; Biomarkers; Birth Weight; Blood Pressure; Case-Control Studies; Female; Fetal Blood; Folic Acid; Gestational Age; Homocysteine; Humans; Infant, Newborn; Infant, Premature; Nutritional Status; Pre-Eclampsia; Pregnancy; Premature Birth; Up-Regulation; Vitamin B 12; Young Adult

Maternal serum concentrations of folate, homocysteine, and vitamin B12 have been associated with pre-eclampsia. Nevertheless, reported studies involve limited number of cases to reliably assess the nature of these associations. Our aim was to examine the relation of these three biomarkers with pre-eclampsia risk in a large Colombian population.. Design: A case-control study. Setting: Cases of pre-eclampsia and healthy pregnant controls were recruited at the time of delivery from eight different Colombian cities between 2000 and 2012. Population or Sample: 2978 cases and 4096 controls were studied. Maternal serum concentrations of folate, homocysteine, and vitamin B12 were determined in 1148 (43.6%) cases and 1300 (31.7%) controls. Also, self-reported folic acid supplementation was recorded for 2563 (84%) cases and 3155 (84%) controls. Analysis: Adjusted odds ratios (OR) for pre-eclampsia were estimated for one standard deviation (1SD) increase in log-transformed biomarkers. Furthermore, we conducted analyses to compare women that reported taking folic acid supplementation for different periods during pregnancy. Main Outcomes Measures: Odds ratio for pre-eclampsia.. After adjusting for potential confounders in logistic regression models, the OR for pre-eclampsia was 0.80 (95% CI: 0.72, 0.90) for 1SD increase in log-folate, 1.16 (95%CI: 1.05, 1.27) for 1SD increase in log-homocysteine, and 1.10 (95%CI: 0.99, 1.22) for 1SD increase in log-vitamin B12. No interactions among the biomarkers were identified. Women who self-reported consumption of folic acid (1 mg/day) throughout their pregnancy had an adjusted OR for pre-eclampsia of 0.86 (95%CI: 0.67, 1.09) compared to women that reported no consumption of folic acid at any point during pregnancy.. Maternal serum concentrations of folate were associated as a protective factor for pre-eclampsia while concentrations of homocysteine were associated as a risk factor. No association between maternal vitamin B12 concentrations and preeclampsia was found.

Topics: Adolescent; Adult; Biomarkers; Case-Control Studies; Colombia; Female; Folic Acid; Homocysteine; Humans; Pre-Eclampsia; Pregnancy; Vitamin B 12; Young Adult

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

Umbilical cord blood (UCB) is in contact with all the fetal tissues and can reflect the state of fetus and UCB can be compared with maternal blood. Inflammatory, metabolic and immunological disorders during pregnancy can affect the environment in which the fetus is developing and may produce various alterations.. To analyze different biochemical parameters in maternal venous blood and new born umbilical cord blood from healthy normotensive pregnant and preeclamptic women.. Homocysteine, folate, B12, heme oxygenase-1 (HO-1), endoglin, leptin, cholinesterase, IGF-1, Apo A, lipoproteins, TSH, fT3, fT4 were analyzed in maternal sera and venous umbilical cord sera of newborns of twenty five preeclamptics (group II) and twenty five normotensive pregnant women (group I). Homocysteine, folic acid, vitamin B12, Apo A I & II, TSH, fT3, fT4 levels were estimated by competitive immunoassay using direct chemiluminiscence technology. Heme oxygenase-1 (HO-1), endoglin, leptin, cholinesterase, IGF-1 were analyzed by ELISA.. Maternal and cord blood levels of homocysteine, folic acid, lipid profile (namely, total cholesterol, triglycerides, LDL-C, VLDL-C and HDL-C), TSH, heme oxygenase 1, were higher in preeclamptic women as compared to normotensive pregnant women. Endoglin levels were significantly lower in cord blood of preeclamptic mother as compared to normotensive mothers. Serum and cord blood vitamin B12, Apo A-I and Apo B l, cholinesterase, leptin levels, IGF-I were lower in preeclamptic women as compared to normotensive pregnant.. Findings of the present study suggest that biochemical alterations occur in mothers and fetuses and modifications of uterine environment (in terms of thyroxine and folate and vitamin B12 supplementation) can be of help.

Topics: Apoprotein(a); Biomarkers; Female; Fetal Blood; Folic Acid; Heme Oxygenase-1; Homocysteine; Humans; Infant, Newborn; Lipids; Pre-Eclampsia; Pregnancy; Thyroid Hormones; Thyrotropin; Vitamin B 12

The present prospective study examines the levels of maternal plasma folate, vitamin B12 and homocysteine in normotensive control (NC) women and women with preeclampsia (PE) from early pregnancy till delivery.. The present study includes 126 NC and 62 PE women. Maternal blood was collected at 3 time points during pregnancy (T1 = 16th-20th weeks, T2 = 26th-30th weeks and T3 = at delivery). Levels of folate, vitamin B12 and homocysteine were estimated by the chemiluminescent microparticle immunoassay technology.. Maternal plasma folate levels were similar between NC and PE women at all the time points across gestation. Maternal plasma vitamin B12 levels were significantly higher in PE (p < 0.05) as compared with NC at T2. Maternal plasma homocysteine levels were higher in PE as compared with NC at all the time points, i.e. T1, T2 (p < 0.05 for both) and T3 (p < 0.01).. Our results indicate that higher homocysteine levels exist in women with PE from early pregnancy and continue till delivery.

Topics: Adult; Diet; Female; Folic Acid; Gestational Age; Homocysteine; Humans; Infant, Newborn; Pre-Eclampsia; Pregnancy; Prospective Studies; Vitamin B 12

To examine the relationship of inherited thrombophilia and other thrombotic risk factors with preeclampsia (PE) in a population of pregnant Turkish women.. This was a case cross-sectional study in which 70 women with PE and 60 normal pregnant women were studied to find out the frequency of women with risk factors including inherited thrombophilia among preeclamptic cases.. Hemoglobin, platelet count, uric acid, vitamin B12, folic acid, copper, homocysteine, plasminogen activator inhibitor-1, fibrinogen, protein S, protein C, activated protein C resistance values show significant differences in women with PE in comparison to women with normal pregnancy.. There may be a link between inherited thrombophilia and PE, at least in a sample of Turkish pregnant women. We also propose that the association between thrombophilia and PE is stronger than suggested previously. Furthermore, copper is selectively elevated in women with PE as an independent marker.

Topics: Cross-Sectional Studies; Female; Folic Acid; Humans; Pre-Eclampsia; Pregnancy; Thrombophilia; Vitamin B 12

Folate, vitamin B12 and vitamin B6 are required for homocysteine metabolism and their deficiency can result in increased homocysteine concentration. Homocysteine concentrations have been found to be increased in late pregnancy toward nonpregnant values.. To study folate, vitamin B12 and homocysteine levels in cord blood and maternal blood in preeclampsia.. One hundred fifty pregnant women attending Out Patient Department of Department of Obstetrics and Gynaecology were recruited for the study. Grouped as: GROUP I (control): Fifty normotensive women with singleton pregnancy immediately after delivery; GROUP II (study): Fifty (age and gestation matched women with singleton pregnancy) women with preeclampsia immediately after delivery; GROUP III (study): Fifty normotensive pregnant women were recruited in first trimester (8-12 weeks) that were followed in second (24-28 weeks) and third trimester (32-36 weeks). Homocysteine, vitamin B12 and folic acid levels were investigated by competitive immunoassay using direct chemiluminiscence technology.. Homocysteine and folic acid levels were higher in maternal blood of hypertensive pregnant women as compared to normotensive pregnant women (p<0.001, p>0.05 respectively). Vitamin B12 levels were lower in maternal blood of hypertensive pregnant women as compared to normotensive pregnant women. Levels of homocysteine were higher in cord blood of hypertensive pregnant women as compared to normotensive pregnant women (p<0.01). Levels of vitamin B12 and folic acid was lower in cord blood of preeclamptic women as compared to normotensive pregnant women (p<0.001, p<0.01 respectively). A negative correlation was found between homocysteine and folic acid levels of mothers in group II that was statistically significant.. Elevated homocysteine and folate and vitamin B12 deficiency during pregnancy may be a risk factor for preeclampsia and future risk of cardiovascular risk.

Topics: Case-Control Studies; Female; Fetal Blood; Folic Acid; Folic Acid Deficiency; Homocysteine; Humans; Hyperhomocysteinemia; Pre-Eclampsia; Pregnancy; Pregnancy Trimesters; Risk Factors; Vitamin B 12; Vitamin B 12 Deficiency

We investigated the correlation between 5,10-methylenetetrahydrofolate reductase (MTHFR) gene methylation and pre-eclampsia, and its clinical significance, by comparing methylation in the MTHFR gene promoter of the placenta and peripheral venous blood in pre-eclampsia and normal gravidas. We enrolled 259 gravidas from the People's Liberation Army 202nd Hospital, China, between January 2011 and September 2011, including 127 pre-eclampsia and 132 nor-mal gravidas. Methylation levels of the MTHFR gene in placentas in two sets of gravidas were detected by methylation-specific polymerase chain reaction, plasma homocysteine levels were detected by enzyme-linked immunosorbent assay, and folic acid and vitamin B12 levels were detected by electrochemiluminescence. The chi-square test results were analyzed using the SPSS19.0 statistical software. In placentas, the methylation indices were 26.8% (34/127) and 15.2% (20/132) in the pre-eclampsia and normal groups, respectively (χ(2) = 5.30, P < 0.05, odds ratio (OR) = 2.04, 95% confidence interval (95%CI) = 1.10-3.73). In peripheral venous blood, the methylation indices were 22.8% (29/127) and 12.1% (16/132) in pre-eclampsia and normal groups, respectively (χ(2) = 5.17, P < 0.05, OR = 2.15, 95%CI = 1.11-4.15). The plasma methylation level of the pre-eclampsia group was consistent with the normal group. The plasma homocysteine level in the pre-eclampsia group was higher than in the normal group (P < 0.05). Levels of folic acid and vitamin B12 in the pre-eclampsia and normal groups were not statistically significant (P > 0.05). Patients with pre-eclampsia have hypermethylation in the MTHFR gene promoter, which may be one of its causes.

Topics: Adult; Case-Control Studies; DNA Methylation; Electrophoresis, Agar Gel; Female; Folic Acid; Homocysteine; Humans; Methylenetetrahydrofolate Reductase (NADPH2); Polymerase Chain Reaction; Pre-Eclampsia; Pregnancy; Vitamin B 12

Good clinical practice recommends folic acid supplementation 1 month prior to pregnancy and during the first trimester to prevent congenital malformations. However, high rates of fetal growth and development in later pregnancy may increase the demand for folate. Folate and vitamins B12 and B6 are required for DNA synthesis and cell growth, and are involved in homocysteine metabolism. The primary aim of this study was to determine if maternal folate, vitamin B12, vitamin B6 and homocysteine concentrations at 18-20 weeks gestation are associated with subsequent adverse pregnancy outcomes, including pre-eclampsia and intrauterine growth restriction (IUGR). The secondary aim was to investigate maternal B vitamin concentrations with DNA damage markers in maternal lymphocytes. A prospective observational study was conducted at the Women's and Children's Hospital, Adelaide, South Australia. One hundred and thirty-seven subjects were identified prior to 20 weeks gestation as at high or low risk for subsequent adverse pregnancy outcome by senior obstetricians. Clinical status, dietary information, circulating micronutrients and genome damage biomarkers were assessed at 18-20 weeks gestation. Women who developed IUGR had reduced red blood cell (RBC) folate (P < 0.001) and increased plasma homocysteine concentrations (P < 0.001) compared with controls. Maternal DNA damage, represented by micronucleus frequency and nucleoplasmic bridges in lymphocytes, was positively correlated with homocysteine (r = 0.179, P = 0.038 and r = 0.171, P = 0.047, respectively). Multivariate regression analysis revealed RBC folate was a strong predictor of IUGR (P = 0.006). This study suggests that low maternal RBC folate and high homocysteine values in mid pregnancy are associated with subsequent reduced fetal growth.

Topics: Adult; Biomarkers; Dietary Supplements; DNA Damage; Erythrocyte Count; Female; Fetal Growth Retardation; Folic Acid; Homocysteine; Humans; Logistic Models; Multivariate Analysis; Pre-Eclampsia; Pregnancy; Pregnancy Outcome; Prospective Studies; South Australia; Vitamin B 12; Vitamin B 6

To investigate associations between early pregnancy homocysteine, folate and vitamin B12 concentrations and placental weight, birthweight and adverse pregnancy outcomes.. Population-based birth cohort study.. Rotterdam, the Netherlands.. Cohort of 5805 pregnant women.. 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.. Placental weight, birthweight, small for gestational age at birth (SGA) (<5th centile), prematurity and pre-eclampsia.. 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.. 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.

Topics: Adult; Birth Weight; Cohort Studies; Female; Folic Acid; Homocysteine; Humans; Infant, Newborn; Infant, Small for Gestational Age; Male; Netherlands; Organ Size; Placenta; Pre-Eclampsia; Pregnancy; Pregnancy Outcome; Risk Factors; Vitamin B 12; Young Adult

Maternal nutrition is an important determinant of the duration of pregnancy and fetal growth, and thereby influences pregnancy outcome. Folic acid and vitamin B(12) are involved in one-carbon metabolism and are reported to underlie intrauterine programming of adult diseases.. In the present study, the levels of folate, vitamin B(12) and homocysteine were measured in mothers delivering preterm (PT; gestation <37 weeks; n = 67), those delivering preterm due to preeclampsia (PT-PE; n = 49) and women delivering at term (control group; n = 76).. Increased vitamin B(12) and homocysteine levels (p < 0.05 for both) were seen in the PT-PE and PT groups as compared to the controls. In addition, reduced folate levels (p < 0.05) were observed in the PT group. A negative association of maternal plasma homocysteine with birth weight was seen in the idiopathic preterm group.. Altered maternal micronutrients and resultant increased homocysteine concentrations exist in women delivering preterm. These alterations may also be partly associated with other factors such as undiagnosed inflammatory conditions or inadequate placentation in some women. Since these micronutrients play an important role in epigenetic regulation of vital genes involved in the fetal programming of adult diseases, further studies need to be undertaken to understand their role in preterm deliveries.

Topics: Adult; Birth Weight; Cross-Sectional Studies; Female; Folic Acid; Homocysteine; Humans; Infant, Newborn; Maternal Nutritional Physiological Phenomena; Micronutrients; Nutrition Assessment; Pre-Eclampsia; Pregnancy; Pregnancy Outcome; Premature Birth; Vitamin B 12; Vitamin B Complex; Young Adult

The present study examines the associations of folic acid, vitamin B₁₂ and omega-3 fatty acids and increased homocysteine which are implicated in the pathology of pre-eclampsia.. 49 Pre-eclamptic and 57 normotensive women were recruited at Bharati hospital, Pune, India. Plasma folate, vitamin B₁₂, homocysteine and erythrocyte omega-3 and omega-6 fatty acids were analyzed.. Homocysteine concentrations were higher in pre-eclamptic than in normotensive women (14.28±7.31 vs. 11.03±4.38 μmol/l, p<0.01) despite similar levels of folic acid and vitamin B₁₂. In the pre-eclamptic group, plasma folate levels were positively associated with erythrocyte omega-6 fatty acids (p<0.05) while erythrocyte docosahexaenoic acid levels were negatively associated with plasma homocysteine levels (p<0.01).. Our study provides evidence for the associations of altered omega-3 fatty acids especially docosahexaenoic acid and the resultant increased homocysteine concentrations in pre-eclampsia. Future studies need to examine if docosahexaenoic acid supplementation during pregnancy reduces homocysteine levels and ameliorates the risk of developing pre-eclampsia.

Topics: Adult; Erythrocytes; Fatty Acids, Omega-3; Fatty Acids, Omega-6; Female; Folic Acid; Homocysteine; Humans; India; Life Style; Pre-Eclampsia; Pregnancy; Prenatal Nutritional Physiological Phenomena; Prospective Studies; Surveys and Questionnaires; Vitamin B 12; Young Adult

The aim of this study was to evaluate maternal and fetal serum levels of homocysteine, folic acid, vitamin B12 and placental tissue levels of homocysteine and their association with severity of pre-eclampsia.. A case-control study, performed by a single center, included 26 pregnant women with mild pre-eclampsia, 26 pregnant women with severe pre-eclampsia and 26 healthy pregnant women. Maternal blood was collected before delivery and fetal blood was collected from the umbilical cord at delivery. Placental tissue samples were obtained after delivery of placenta. Homocysteine, folic acid, vitamin B12 levels in serum and homocysteine levels in placental tissue homogenates were analyzed by immunochemiluminescent assay.. Homocysteine levels in both maternal and fetal serum were significantly higher in the severe pre-eclampsia group compared to mild pre-eclampsia and control groups. However, homocysteine levels in both maternal and fetal serum were not significantly different between mild pre-eclampsia and control groups. No significant differences were observed in folic acid and vitamin B12 levels in both maternal and fetal serum between the groups. Homocysteine levels in placental tissue homogenates were too low to be measured in the three groups (<2 µmol/l).. Maternal and fetal serum homocysteine levels were found to be significantly higher in severe pre-eclampsia group compared to mild pre-eclampsia and control groups suggesting that elevated serum levels of homocysteine might be associated with severity of pre-eclampsia. On the other hand it seems like elevated serum homocysteine levels were not associated with deficiency of folic acid and vitamin B12.

Topics: Adult; Case-Control Studies; Female; Fetal Blood; Folic Acid; Homocysteine; Humans; Hyperhomocysteinemia; Nutritional Status; Placenta; Pre-Eclampsia; Pregnancy; Severity of Illness Index; Vitamin B 12

Maternal nutrition is an important determinant of one-carbon metabolism that lies at the heart of intrauterine epigenetic programming. Exchange of nutrients and other vital molecules between the mother and fetus takes place across the placenta and hence may play direct role in fetal programming. Pre-eclampsia (PE) originates in the placenta and altered maternal nutrition may influence epigenetic patterns in the placenta, thereby affecting birth outcome. In the present study, we investigated the global DNA methylation levels in placentas of pre-eclampsia women (i.e., women delivering at term and those delivering preterm) and studied their associations with maternal blood pressure and birth outcome. Increased homocysteine and global DNA methylation levels were seen in the pre-eclampsia group (term and preterm PE) when compared with the normotensive group (p < 0.05). A positive association between global DNA methylation and systolic (p < 0.01) and diastolic (p < 0.05) blood pressure was seen in the term pre-eclampsia group, whereas there was no association with birth outcome. The study for the first time provides evidence for altered global DNA methylation patterns in pre-eclampsia placentas and its association with blood pressure. It is possible that increased homocysteine levels may be related to increased methylation in pre-eclampsia.

Topics: Blood Pressure; DNA Methylation; Female; Folic Acid; Homocysteine; Humans; Hypertension; Infant, Newborn; Mothers; Placenta; Pre-Eclampsia; Pregnancy; Premature Birth; Term Birth; Vitamin B 12

The role of folate in pregnancy is well established, with most prenatal vitamins (PNVs) on the market containing at least 800 μg of folic acid. Folic acid must be converted in the body to L-methylfolate, the natural and biologically active form of folate. The role of vitamin B(12) in pregnancy is less characterized, and most PNV formulations contain only 0 to 12 μg. The present study was undertaken to evaluate whether taking a prenatal medical food containing L-methylfolate and much higher doses of vitamin B(12) results in higher hemoglobin levels and thus, a lower incidence of anemia during pregnancy.. The objective of this exploratory study was to evaluate the effects of the prenatal medical food versus standard PNVs on hemoglobin levels and adverse outcomes throughout pregnancy.. For this retrospective analysis, we reviewed the charts of female patients taking either a prenatal medical food or standard PNV during pregnancy. Hemoglobin levels measured at initiation of prenatal care, end of second trimester, and delivery were recorded. Patients who had received additional iron supplementation, beyond that contained in the prenatal medical food or PNV they were taking and before anemia screening at the end of the second trimester, were excluded from the study. Fisher exact test, χ(2) test, student t test, and ANOVA were used to evaluate differences between the treatment groups.. Data were analyzed from 112 charts: 58 patients (51.8%) were taking the prenatal medical food; 54 patients (48.2%) were taking standard PNVs. Mean (SD) age at first prenatal visit was 27 (4.6) years in the medical food group and 28.8 (3.5) years in the PNV group (P = 0.024). Mean (SD) body mass indices were 29.1 (6.5) and 31.7 (8.9) in the medical food and PNV groups, respectively (P = NS). In the medical food group, 35 women (60.3%) were white/Caucasian, 17 (29.3%) were African American, and 6 (10.4%) were of other races. In the PNV group, 24 women (44.4%) were white/Caucasian, 25 (46.3%) were African American, and 5 (9.3%) were of other races. However, race was not significantly different between the two groups. At end of second trimester and at delivery, mean (SD) hemoglobin levels were higher in the prenatal medical food group (11.8 [1.1] g/dL and 11.8 [1.3] g/dL, respectively) than in the PNV group (11.3 [1.2] g/dL and 10.7 [1.2] g/dL, respectively) (P = 0.011 and P = 0.001, respectively). Significantly fewer cases of anemia were reported at end of second trimester in the prenatal medical food group than in the PNV group (39.7% vs 74.1%; P = 0.001).. In the present study, supplementation with a prenatal medical food containing L-methylfolate and high-dose vitamin B(12) may maintain hemoglobin levels and decrease rates of anemia in pregnancy more effectively than standard prenatal vitamins; however, prospective, controlled studies are warranted. ClinicalTrials.gov identifier: NCT01193192.

Topics: Adult; Anemia; Clinical Trials as Topic; Docosahexaenoic Acids; Female; Folic Acid; Food, Fortified; Hemoglobins; Humans; Incidence; Pre-Eclampsia; Pregnancy; Pregnancy Complications, Hematologic; Pregnancy Outcome; Pregnancy Trimester, Second; Prenatal Care; Retrospective Studies; Vitamin B 12; Vitamins; Young Adult

To assess the levels and clinical significance of high sensitive(hs)-CRP (C-reactive protein), IL-6(interleukin-6), TNF-alpha(tumor necrosis factor-alpha), homocysteine, folic acid and vitamin B12 in normotensive healthy pregnant women, mild and severe preeclamptic patients, and to evaluate the correlations between these markers and the severity of preeclampsia and fetal birth weight.. Using a cross-sectional study design, hs-CRP, IL-6, TNF-alpha, homocysteine and vitamin B12 were measured in the third trimester of pregnancy from normotensive healthy women with uncomplicated pregnancies (n = 62), mild (n = 61) and severe (n = 60) preeclamptic patients.. There were statistically significant differences between three groups for hs-CRP (p = 0.012), TNF- alpha (p = 0.046), IL-6 (p = 0.015), homocysteine (p < 0.001) and fetal birth weight (p < 0.001). Fetal birth weights in mild (2477 +/- 746) and severe (2435 +/- 768) preeclamptic patients were significantly lower than controls (3485 +/- 365) (p < 0.001). No significant difference was found between the three groups for folic acid (p = 0.066) and vitamin B12 (p = 0.286). Bonferroni adjusted multiple comparison test showed that the statistical differences with respect to TNF-alpha, IL-6 and homocysteine were mainly created by control and severe preeclampsia groups. Hs-CRP levels still remained higher in severe preeclampsia patients than mild preeclampsia and normotensive patients except for overweight patients in the previous two groups after Bonferroni post hoc adjustment test.. Elevated maternal serum levels of hs-CRP, TNF- alpha, IL-6 and homocysteine in preeclamptic women correlate with fetal birth weight in the early third trimester.

Topics: Adult; Biomarkers; Birth Weight; C-Reactive Protein; Cross-Sectional Studies; Female; Folic Acid; Homocysteine; Humans; Infant, Low Birth Weight; Infant, Newborn; Interleukin-6; Pre-Eclampsia; Pregnancy; Pregnancy Trimester, Third; Tumor Necrosis Factor-alpha; Vitamin B 12; Young Adult

Elevated plasma homocysteine has been implicated in vascular changes compatible with atherosis and endothelial dysfunction similar to the vascular changes of the placenta in preeclampsia. Previous reports have indicated an increased incidence of hyperohomocysteinemia in preeclamptic patients. The aim of this study was to examine the association of homocysteine levels and preeclampsia in our patients.. Prospective study of 28 preeclamptic patients that were matched with 26 normal controls of the same gestational age.. The preeclamptic group had an increased incidence of cesarean sections (75%), of growth retarded fetuses (50%), intrauterine deaths (7%) and placental abruptions (7%). Mean levels of homocysteine were significantly elevated in the preeclamptic than in control group (11.11 vs. 6.40 micromol/l, P < 0.001). There were no differences between the groups regarding the levels of folic acid (11.12 vs. 9.73 ng/ml, P = 0.55) and vitamin B12 (295.76 vs. 356.15 pg/ml, P = 0.43).. It is concluded that in our study homocysteine levels are significantly elevated in patients with preeclampsia compared with control group, while no vitamin deficiencies were observed.

Topics: Adult; Female; Folic Acid; Homocysteine; Humans; Hyperhomocysteinemia; Pre-Eclampsia; Predictive Value of Tests; Pregnancy; Pregnancy Outcome; Prospective Studies; Risk Factors; Vitamin B 12

To evaluate the possible relationship between preeclampsia and polymorphisms in the main genes involved in folate-homocysteine metabolism.. Case-control study: 43 patients with preeclampsia and 122 controls without pregnancy complications. Laboratory studies: tHcy and other amino acids, folate and vitamin B(12) and polymorphisms: 677C > T and 1298A > C (MTHFR); 699C > T, 844ins68 and 1080C > T (CBS); 2756A > G (MTR); and 66G > A, IVS1+766G > A and IVS1+754A > C (MTRR).. Plasma tHcy and folate values were significantly higher (P = 0.004 and P = 0.019), while Met/tHcy ratios were lower (P < 0.001) in the patients compared with controls. No association was observed between polymorphisms tested and preeclampsia. In the control group, four such associations were found: the 1298A > C polymorphism (MTHFR) with the ratio Met/tHcy (P = 0.014); the 699C > T polymorphism (CBS) with the ratio tHcy/SigmaAA (P = 0.013); the 2756A > G polymorphism (MTR) with tHcy (P = 0.034); and the IVS1+766G > A polymorphism (MTRR) with hyperhomocysteinemia (P = 0.012).. An association between the polymorphisms analysed and preeclampsia could not be demonstrated.

Topics: 5-Methyltetrahydrofolate-Homocysteine S-Methyltransferase; Adult; Case-Control Studies; Cystathionine beta-Synthase; Female; Ferredoxin-NADP Reductase; Folic Acid; Homocysteine; Humans; Hyperhomocysteinemia; Methylenetetrahydrofolate Reductase (NADPH2); Polymorphism, Genetic; Pre-Eclampsia; Pregnancy; Vitamin B 12

Black women have an increased risk of preeclampsia compared with white women. Plasma homocysteine is increased in preeclampsia. Homocysteine concentrations are affected by nutritional deficiencies, particularly decreased folic acid and B12, leading to increased homocysteine. Previous studies have reported racial differences in nutritional intake including folic acid. Therefore, we investigated whether there were racial differences in plasma homocysteine, folic acid, and vitamin B12 among women with preeclampsia. We tested for an association between homocysteine and folic acid and B12, and we hypothesized an inverse relationship of homocysteine and folic acid in preeclampsia, more so in black women in whom preeclampsia developed. Black women with preeclampsia (n=26) had elevated homocysteine concentrations (8.7+/-1.4 micromol/L) compared with black women with normal pregnancy (n=52, 7.6+/-0.5 micromol/L), white women with preeclampsia (n=34, 7.5+/-0.6 micromol/L), and white women with normal pregnancy (n=48, 5.5+/-0.3 micromol/L). Folic acid concentrations were lower in black women (14.1+/-0.8 ng/mL) compared with white women (18.5+/-0.9 ng/mL, P<0.01). However, plasma homocysteine was inversely related to folic acid only among black women with preeclampsia (r=-0.23, P=0.01). These racial differences may have implications for the higher rates of preeclampsia in this group and may have long-term implications for future cardiovascular risk. Racial differences in diet, adherence to folic acid supplementation, or interactions of nutritional and maternal factors warrant further study by race and pregnancy status.

Topics: Adolescent; Adult; Arteriosclerosis; Black People; Female; Folic Acid; Homocysteine; Humans; Hyperhomocysteinemia; Maternal Age; Pennsylvania; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Risk Factors; Vitamin B 12; White People

Hyperhomocysteinemia is a risk factor in obstetrical complications such as pre-eclampsia, 'hemolysis, elevated liver enzymes, low platelet' (HELLP)-syndrome and placental insufficiency. The aim of our study was to investigate the alterations of homocysteine catabolism in these patients in relation to serum B-vitamins and renal function. Maternal fasting serum from pre-eclampsia (n=24), HELLP (n=20) and placental insufficiency (n=25) patients at the time of diagnosis and pregnant controls (n=34) was analyzed for homocysteine and its metabolites cystathionine and methylmalonic acid, the vitamins B6, B12 and folate, renal and additional parameters. Cystathionine, a parameter of homocysteine catabolism, was significantly increased in pre-eclampsia and HELLP compared with controls and placental insufficiency patients (mean concentrations: 343, 324, 248, 227 nmol/l; p=0.001). Homocysteine, folic acid, vitamin B6 and methylmalonic acid, however, did not differ significantly between groups. The main determinants of cystathionine are cystatin C and vitamin B6, whereas the main determinants of homocysteine are folate and uric acid. The strongest dependency of cystathionine on vitamin B6 was observed in pre-eclampsia and HELLP patients. The results suggest that the vitamin B6-dependent trans-sulfuration pathway is activated in pre-eclampsia and HELLP syndrome, probably by oxidative stress. Therefore, the demand for vitamin B6 is increased in these patients. Furthermore, renal dysfunction and low vitamin B6 levels contribute to the increase of cystathionine in pre-eclampsia and HELLP patients.

Topics: Cystathionine; Cystatin C; Cystatins; Female; Folic Acid; HELLP Syndrome; Homocysteine; Humans; Hyperhomocysteinemia; Kidney Function Tests; Methylmalonic Acid; Oxidative Stress; Placental Insufficiency; Pre-Eclampsia; Pregnancy; Severity of Illness Index; Uric Acid; Vitamin B 12; Vitamin B 6

(a) To establish the reference values for plasma total homocysteine in our pregnant population. (b) To determine the possible association between hyperhomocysteinemia and preeclampsia in our geographical area.. Control-case study with 32 preeclamptic patients and 64 controls without pregnancy complications. Plasma total homocysteine, determined by HPLC (fluorescence detection), was correlated with serum folate and Vitamin B(12) (analyzed by competitive protein binding chemiluminescent assay).. Mann-Whitney, Wilcoxon and Spearman test (SPSS, 10.0).. Homocysteine concentrations in the controls were significantly higher while folate was significantly lower in the third trimester of pregnancy when compared with the second (P<0.0001). Homocysteine and folate values were significantly higher in patients compared with controls in the third trimester (P=0.005 and 0.005, respectively). The OR for preeclampsia in hyperhomocysteinemia was 7.7 (95% CI: 1.7-34.8).. Pregnant women with hyperhomocysteinemia have a 7.7-fold risk for preeclampsia (CI 95%: 1.7-34.8) compared with normal controls.

Topics: Case-Control Studies; Chromatography, High Pressure Liquid; Female; Folic Acid; Gestational Age; Homocysteine; Humans; Hyperhomocysteinemia; Pre-Eclampsia; Pregnancy; Pregnancy Trimester, Third; Vitamin B 12

To evaluate a). the plasma amino acid changes observed in pregnant women (n = 124) and b). the homocysteine and other amino acid changes in preeclampsic patients (n = 18), and to determine c) whether these changes were also evident in nonpregnant women with a prior history of preeclampsia (n = 18).. Case-control study. Plasma total homocysteine (tHcy): HPLC with fluorescence detection, and amino acids (AA): ion exchange chromatography.. a). Significantly lower absolute AA values were observed in the pregnant controls for homocysteine, total, essential, and nonessential AA compared with nonpregnant controls. b. In preeclampsia, significantly higher absolute values of tHcy, total, essential and nonessential AA were observed, but relative values referred to total AA were not different. These changes corrected after delivery.. Hyperhomocysteinemia and an increase in most AA levels were observed in preeclampsia. Relative AA values suggested that these changes might be explained by fluctuations in plasma volume. Abnormal AA levels corrected after delivery.

Topics: Adult; Amino Acids; Case-Control Studies; Chromatography, High Pressure Liquid; Chromatography, Ion Exchange; Data Interpretation, Statistical; Female; Folic Acid; Homocysteine; Humans; Pre-Eclampsia; Pregnancy; Pregnancy Trimester, Second; Pregnancy Trimester, Third; Vitamin B 12

The authors measured maternal third trimester plasma folate, vitamin B(12), and homocyst(e)ine concentrations among 125 women with preeclampsia and 179 normotensive women in Lima, Peru (1997-1998), to determine whether these analytes were associated with the occurrence of preeclampsia. Logistic regression procedures were used to calculate maximum likelihood estimates of odds ratios and 95% confidence intervals. Relative to women in the upper quartile of the control distribution of maternal plasma folate concentrations, women with values in the lowest quartile experienced a 1.6-fold increased risk of preeclampsia (odds ratio = 1.6; 95% confidence interval: 0.8, 3.2). There was no evidence of an increased risk of preeclampsia associated with low plasma vitamin B(12) concentrations. The unadjusted relative risk of preeclampsia increased across successively higher quartiles of plasma homocyst(e)ine level (odds ratios were 1.0, 1.0, 1.5, and 2.9, respectively, with the lowest quartile used as the referent; p for linear trend = 0.0004). After adjustment for maternal age, parity, gestational age, use of prenatal vitamins, whether the pregnancy had been planned, and educational attainment, the relative risk between extreme quartiles was 4.0 (95% confidence interval: 1.8, 8.9). These findings are consistent with earlier reports suggesting that hyperhomocyst(e)inemia in pregnancy may be a risk factor for preeclampsia.

Topics: Adult; Case-Control Studies; Female; Folic Acid; Homocysteine; Humans; Hyperhomocysteinemia; Logistic Models; Odds Ratio; Peru; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy Trimester, Third; Surveys and Questionnaires; Vitamin B 12

This study was undertaken to assess frequencies of the methylenetetrahydrofolate reductase gene mutations cytosine-to-thymine substitution at base 677 (C677T) and adenine-to-cytosine substitution at base 1298 (A1298C) and their interactions with homocysteine and vitamin levels among Dutch women with preeclampsia.. Mutations were studied in the following 5 groups: 47 consecutive women with preeclampsia, 49 women with preeclampsia and with hyperhomocysteinemia, 36 women with preeclampsia but without hyperhomocysteinemia, 127 women with familial preeclampsia (typed for C677T mutations only), and 120 control subjects. Plasma levels of homocysteine, folate, and vitamin B12 were measured.. Although 10.6% of the consecutive women with preeclampsia had strictly defined hyperhomocysteinemia (values >97.5th percentile), neither mutation was found in excess relative to the control group. Women with preeclampsia who had mild hyperhomocysteinemia (values >75th percentile) had a significant excess of the TT genotype (homozygosity for C677T mutation) relative to the women with preeclampsia who did not have hyperhomocysteinemia (odds ratio, 8.2; 95% confidence interval, 1.8-39). They also had significantly lower vitamin levels.. Hyperhomocysteinemia in women with preeclampsia was associated with mutations in the gene for methylenetetrahydrofolate reductase, but the high frequency of hyperhomocysteinemia itself cannot be explained by these mutations alone.

Topics: Birth Weight; Deoxyribonucleases, Type II Site-Specific; DNA; DNA Primers; Electrophoresis, Polyacrylamide Gel; Female; Folic Acid; Genotype; Gestational Age; HELLP Syndrome; Homocysteine; Humans; Infant, Newborn; Linear Models; Methionine; Methylenetetrahydrofolate Reductase (NADPH2); Mutation; Oxidoreductases Acting on CH-NH Group Donors; Polymerase Chain Reaction; Pre-Eclampsia; Pregnancy; Radioimmunoassay; Regression Analysis; Vitamin B 12

We conducted a case control study at Harare Maternity Hospital, Zimbabwe. We genotyped a total of 171 cases with preeclampsia or eclampsia and 185 normotensive control subjects for the methylenetetrahydrofolate reductase (MTHFR) 677 C --> T genotype. The wild-type allele frequency among cases and controls was 91.2 and 91.3%, respectively. Only one subject (0.3%) was homozygous for the 677 C --> T MTHFR genotype and this subject had preeclampsia. After adjustment for confounding factors, there was statistically no significant association between maternal MTHFR genotype and risk of preeclampsia (adjusted odds ratio = 1.0; 95% CI, 0.5-1.9). In addition, plasma homocyst(e)ine, vitamin B(12), and folate concentrations were not statistically different between normotensive control subjects with wild-type genotype as compared with normotensive subjects who were heterozygous for the mutant allele. Conversely, there was a strong graded association between maternal plasma folate concentration and risk of preeclampsia. Women with plasma folate concentrations less than 5.7 nmol/L experienced a 10. 4-fold increase in risk of preeclampsia. There was no clear pattern of preeclampsia risk and vitamin B(12) concentrations.

Topics: Adolescent; Adult; Alleles; Black People; Case-Control Studies; Female; Folic Acid; Gene Frequency; Genetic Predisposition to Disease; Genotype; Homocysteine; Humans; Methylenetetrahydrofolate Reductase (NADPH2); Mutation; Nutritional Physiological Phenomena; Odds Ratio; Oxidoreductases Acting on CH-NH Group Donors; Polymorphism, Single Nucleotide; Pre-Eclampsia; Pregnancy; Risk Factors; Vitamin B 12; Zimbabwe

To examine erythropoiesis in renal transplant pregnancies.. Retrospective cohort study of 30 renal transplant cases and 30 age, smoking and parity-matched healthy controls with normal index pregnancy. Retrospective chart review and assay of frozen antenatal serum (for serum erythropoietin concentration [serum EPO]), transferrin receptor protein [TfR], ferritin, folate and B12) were performed. The linear regression equation for normal pregnancy controls was used to calculate predicted [serum EPO] and the observed/predicted (O/P) log [serum EPO] was plotted. The relationship between [serum EPO] and haemoglobin (Hb) among transplant cases was considered to be different from that among controls if the slope of the O/P log [serum EPO] versus Hb regression was significantly different from zero.. The transplant (14 cadaveric) to conception interval was (median [range]) 33.5 [4, 189] months. Immunosuppressants were azathioprine (n = 25), cyclosporine (n = 22) and/or prednisone (n = 25). Cases were more often primiparous (20 vs. 7 [controls]; p = 0.01), had pre-existent hypertension (20 vs. 0 [controls]; p < 0.001), developed new/increased hypertension or pre-eclampsia (28 vs. 0 [controls]; p < 0.001) and an antenatal rise in creatinine (14 vs. 2 [controls]; p < 0.001). In early pregnancy, cases had similar EPO (15.2 [2.6, 84.6] vs. 15.7 [6.4, 41.0] [controls] U/L) but lower Hb (101 [65, 129] vs. 116 [106, 150] g/L; p < 0.001). Twenty-two (73%) cases had Hb < 100 g/L (vs. 4 [controls]; p < 0.0001); Hb was comparable at 6 wk postpartum. With advancing gestational age (GA), Hb remained stable and serum EPO increased in both groups. The slope of the O/P log [serum EPO] versus Hb for transplant cases was significantly different from zero within both the 17-28 wk (slope +/- SEM: 0.010 +/- 0.002; p < 0.0001) and the 29-42 wk GA categories (0.006 +/- 0.003; p = 0.02). Cases showed smaller rises in serum TfR (change 481 [- 1471, 2780]) vs. 1119 [- 698, 4195] [controls] ng/mL; p = 0.005).. Anaemia frequently complicates renal transplant pregnancies, in which serum EPO is inappropriately low and the rate of erythropoiesis blunted.

Topics: Adult; Anemia; Case-Control Studies; Cohort Studies; Creatinine; Erythropoiesis; Erythropoietin; Female; Ferritins; Folic Acid; Gestational Age; Hemoglobins; Humans; Hypertension; Immunosuppressive Agents; Kidney Transplantation; Linear Models; Parity; Pre-Eclampsia; Pregnancy; Pregnancy Complications, Cardiovascular; Pregnancy Complications, Hematologic; Receptors, Transferrin; Retrospective Studies; Time Factors; Vitamin B 12

To determine whether homocyst(e)ine, a relatively new risk factor for possible endothelial cell dysfunction and premature vascular disease, is elevated in nulliparous pregnant women with preeclampsia.. We measured plasma homocyst(e)ine, folic acid, and vitamin B12 levels in 40 nulliparas, 20 with and 20 without preeclampsia at the time of their delivery.. Mean (+/- standard deviation) plasma homocyst(e)ine levels in the 20 nulliparous women with preeclampsia were significantly higher than in the 20 nulliparous women without preeclampsia (8.66 +/- 3.05 versus 4.99 +/- 1.11 mumol/L, P < .001). Folic acid and vitamin B12 concentrations were not significantly different between the two groups.. Homocyst(e)ine levels are elevated in pregnant nulliparas with preeclampsia at the time of their delivery. Further studies are necessary to determine what role homocyst(e)ine may play in the etiology of preeclampsia.

Topics: Adult; Case-Control Studies; Female; Folic Acid; Homocysteine; Humans; Parity; Pre-Eclampsia; Pregnancy; Risk Factors; Vascular Diseases; Vitamin B 12

Maternal blood and milk iron (Fe), folate (FA), vitamin B12 (B12) and serum ferritin (Fr) were determined in four groups of lactating mothers: normal, toxemic, anemic and treated anemic during pregnancy. 1. An increasing blood Fe, Fr and a decreasing milk Fe with time in postpartum were found in each group. A high level of blood Fe, Fr was observed in the treated group. Milk Fe, however, had showed no significant difference in either group. There was no correlation between the blood and milk Fe. 2. There was no demonstrable change of blood FA, but milk FA had significantly increased in each group. Blood FA showed a low level in the toxemic group and a high level in the treated group, but no significant difference of milk FA could be found in either group. No matter how widely the level of blood FA spread, there was a little change in milk FA. 3. An increasing blood B12 and a decreasing milk B12 were found in each group. There was a tendency towards a high level of blood B12 in the treated group, but the level of milk B12 differed widely from one material to the other. There was no correlation between the blood and milk B12.

Topics: Anemia; Female; Ferritins; Folic Acid; Humans; Iron; Milk, Human; Postpartum Period; Pre-Eclampsia; Pregnancy; Pregnancy Complications, Hematologic; Vitamin B 12

After introductory remarks on the physiology of blood during pregnancy the authors enter the two most frequent anaemias of pregnancy, which are evoked by iron deficiency and infection, as well as the megaloblastic, which are evoked by deficiency of folic acid--more infrequently also by deficiency of vitamin B12. The diagnostic and therapeutic principles are described in detail. It is only in short referred to the very rare haemolytic and toxic farms of anaemia, it is generally renounced to describe the haemorrhagic anaemia. A prophylaxis of the anaemia of pregnancy is intensely recommended.

Topics: Anemia; Anemia, Megaloblastic; Female; Folic Acid; Humans; Iron; Iron Deficiencies; Pre-Eclampsia; Pregnancy; Pregnancy Complications, Hematologic; Vitamin B 12

Topics: Amniocentesis; Amniotic Fluid; Female; Fetal Death; Folic Acid; Humans; Pre-Eclampsia; Pregnancy; Pyridoxine; Riboflavin; Vitamin B 12; Vitamin B Complex

In pregnancy the level of serum vitamin B(12) is lower in women who smoke than in non-smokers. This finding occurs independently of social class, parity, or level of haemoglobin. In addition, the mean serum B(12) level tends to be less in women who are anaemic and is less in those women who have smaller babies. These findings may be an effect of the cyanide content of tobacco smoke, since cyanide may be detoxified by a mechanism which depletes the stores of vitamin B(12) in the body.

Topics: Anemia; Biotransformation; Birth Weight; Cyanides; Female; Gestational Age; Humans; Hypertension; Parity; Pre-Eclampsia; Pregnancy; Pregnancy Complications, Hematologic; Smoking; Social Class; Vitamin B 12

Topics: Ambulatory Care; Ascorbic Acid; Female; Fetus; Folic Acid; Humans; Niacinamide; Pre-Eclampsia; Pregnancy; Vitamin B 12

Topics: Acetylcholine; Adult; Atropine; Cholinesterases; Female; Humans; Pre-Eclampsia; Pregnancy; Vitamin B 12

Topics: Adolescent; Adult; Aged; Blood; Cerebrovascular Disorders; Cobalt Isotopes; Coronary Disease; Female; Glomerular Filtration Rate; Humans; Hypercholesterolemia; Hypertension; Male; Middle Aged; Pre-Eclampsia; Pregnancy; Statistics as Topic; Uric Acid; Vitamin B 12

Topics: Eclampsia; Female; Humans; Pre-Eclampsia; Pregnancy; Vitamin B 12

Topics: Eclampsia; Female; Humans; Pre-Eclampsia; Pregnancy; Vitamin B 12