Hyperhomocysteinemia: a risk factor for placental abruption or infarction

Abstract

Objective: To establish the prevalence o f hyperhomocysteinemia in women with placental abruption or infarction. Design: Fortysix women with normal pregnancy outcome (controls) and 84 women with placental abruption or infarction (study group) were selected, and studied in the non-pregnant state. Homocysteine metabolism was investigated by a standardized oral methionine loading test. Hyperhomocysteinemia was defined as a concentration of fasting and/or postmethionine plasma homocysteine ex ceeding the estimated 97.5 percentile level o f the controls. In the fasting state, the vitamin status was investigated by the measure ment of serum and red cell folate, serum vitamin B12, and whole blood pyridoxal-5'-phosphate (PLP, an active form o f vitamin B6). Results: Hyperhomocysteinemia was diagnosed in four controls (9%) and 26 women o f the study group (31%, P < 0.05). The median concentrations of the vitamins studied were significantly lower in women o f the study group as compared to the controls, except for red cell folate, where the median concentration was comparable in both groups, The median concentration o f fasting plasma homocysteine, unlike post-methionine plasma homocysteine, was significantly higher in women who experienced placental abruption or infarction in their first pregnancy than in women who had the same event after one or more uncomplicated pregnan cies. Conclusion: Hyperhomocysteinemia is associated with placental abruption or infarction.

Folic acid supplement decreases the homocysteine increasing effect of filtered coffee. A randomised placebo-controlled study

“…There are three main public health concerns with regard to increased plasma homocysteine levels: increased risk of cardiovascular diseases (Clarke et al, 1991;Boushey et al, 1995;Ueland et al, 2000), reproductive hazards (Wouters et al, 1993;Goddijn-Wessel et al, 1996;Leeda et al, 1998;Sorensen et al, 1999;Nelen et al, 2000;Vollset et al, 2000a, b;Refsum, 2001) and the possible association to cognitive disorders (Clarke et al, 1998;McCaddon et al, 2001;Seshadri et al, 2002). The effect of increased plasma homocysteine levels on certain reproductive hazards is currently accepted as causal, whereas the effect on coronary heart disease is still under investigation and awaits the results of intervention studies (Ubbink & Delport, 2000;Ueland et al, 2000).…”

“…Elevated concentrations of the endogenous sulphur amino compound, homocysteine (total homocysteine, tHcy), have been identified as an independent risk factor for coronary heart disease (Clarke et al, 1991;Boushey et al, 1995;Ueland et al, 2000), recurrent early spontaneous abortions (Wouters et al, 1993;Goddijn-Wessel et al, 1996;Nelen et al, 2000), neural tube defects (Vollset et al, 2000a, b;Refsum, 2001) as well as other reproductive and fetal hazards (Leeda et al, 1998;Sorensen et al, 1999). The levels of plasma and serum tHcy are increased not only in folate deficiency, but also at folate levels in the lower reference range (Jacobsen et al, 1994).…”

The association of idiopathic recurrent early pregnancy loss with polymorphisms in folic acid metabolism-related genes

“…Hyperhomocysteinemia (HHcy) has been reported to be an independent risk factor for many pregnancy-related disorders such as neural tube defects, placental abruption or infarction, preeclampsia and unexplained recurrent miscarriage (Wouters et al 1993;Goddijn-Wessel et al 1996;Ray and Laskin 1999;Wenstrom et al 2000). Genetic and environmental factors including metabolism can result in homocysteine (Hcy) accumulation in plasma, subsequently, lead to the occurrence of HHcy.…”

Effects of the interaction between the C677T 5,10-methylenetetrahydrofolate reductase polymorphism and serum B vitamins on homocysteine levels in pregnant women

“…Elevated total serum homocysteine concentration in pregnant women is an important issue as it is known to be related to many adverse pregnancy outcomes including birth defects (Mill et al, 1995;Rosenquist et al, 1995), pre-eclampsia (Leeda et al, 1998), placental abruption (Goddijn-Wessel et al, 1996), spontaneous abortion (Wouters et al, 1993), low birth weight (Burke et al, 1992), and other maternal or fetal complications (Aubard et al, 2000;Scholl & Johnson, 2000).…”