Plasma carnitine concentrations in pregnancy, cord blood, and neonates and children

Winter, Susan; Linn, Lawrence S.; Helton, Edward D.

doi:10.1016/0009-8981(95)06148-7

Cited by 22 publications

(21 citation statements)

References 30 publications

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“…The long-chain acylcarnitine levels were generally lower in the cord blood as compared with the mothers (C16-and C18-carnitines), which may correlate with a more active fatty acid catabolism of the long-chain fatty acids in the mothers than in the neonates. The free carnitine in the cord blood was lower than in the nonpregnant women; this observation is in accordance with the previous data of others (23)(24)(25). Meanwhile, the free, C2-, total acyl-, and total carnitine (sum of free carnitine and all carnitine esters) concentrations in the newborns were between the maternal and the nonpregnant control levels.…”

Section: Discussionsupporting

confidence: 91%

“…During the second part of the pregnancy, we observed a decreased level of the free carnitine and carnitine esters, which was already documented also by others, who used the classic radioenzymatic free carnitine assays (22)(23)(24)(25). By contrast, the coupled alkaline hydrolysis based determination methods, which was used in the previous decades of the carnitine research, could not provide information on the individual carnitine esters.…”

Section: Discussionmentioning

confidence: 49%

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Determination of Carnitine Ester Patterns During the Second Half of Pregnancy, at Delivery, and in Neonatal Cord Blood by Tandem Mass Spectrometry: Complex and Dynamic Involvement of Carnitine in the Intermediary Metabolism

et al. 2007

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ABSTRACT:We studied plasma concentrations of free carnitine and 30 carnitine esters by electron spray ionization (ESI) tandem mass spectrometry in 37 pregnant women at the 20th and 30th weeks of gestation and at delivery, and in their neonates at birth, and in 22 age-matched nonpregnant women. The plasma levels of acetylcarnitine and carnitine esters with more than five carbons were significantly higher, whereas the concentration of free carnitine was significantly lower at term than at the 20th week of pregnancy (16.75 Ϯ 0.89 versus 19.61 Ϯ 1.25). Almost all of C2-to C12-carnitine esters were significantly lower, whereas C16-and C18-carnitines with in-chain modifications were significantly higher in mothers at delivery compared with nonpregnant women. Plasma levels of free carnitine and C2-, C3-, C4-, C5-, C6-, and C16-carnitines were significantly lower, while concentrations of carnitine esters with 8, 10, 12 and 18 carbons in the acyl chain as well as C14:1-, C14:2-, and C16:1-OH-carnitines were significantly higher in mothers at term than in their neonates. The data of the present study clearly show dynamic features of plasma carnitine profile during pregnancy and indicate an extraordinarily active participation of the carnitine in the intermediary metabolism both in the pregnant woman and in the neonate. (Pediatr Res 62: 88-92, 2007) D uring the first two trimesters of pregnancy, the maternal metabolism continuously adapts, with accretion of fat stores deriving from aliments and then shifting to an accelerated catabolism of lipids in the late gestation (1). In human newborns, fat represents 15-16% of total body composition, and the accumulation of white adipose tissue occurs predominantly during the last trimester (2).Carnitine is a conditionally essential quaternary amino acid that plays a crucial role in beta-oxidation of long-chain fatty acids and in ketogenesis (3-5). The carnitine molecule can form esters with FFA of different chain length; the endogenous (4) or exogenous acyl groups (6 -8) are transferred from coenzyme-A to carnitine by different carnitine acyltransferases (9).Availability of carnitine has been reported to be essential for the developing fetus (10,11), and carnitine is stored in increasing amounts in fetal tissues, mainly in the liver and muscle, during the last period of gestation (12). Fetal carnitine is derived from the mother via transplacental transfer of carnitine (13). The Na ϩ -dependent high-affinity carnitine transporter OCTN2 (14,15) is expressed in human placenta (16), and placental OCTN2 is necessary for the accumulation of carnitine in placenta and fetus, and, consequently, for the oxidation of long-chain fatty acids in fetal-placental unit (17,18). Studies on OCTN2 -/-mice suggest that the placental carnitine synthesis might depend on the carnitine status of the fetus and/or the mother (13). On the basis of these observations, it is clear that further studies of maternal and neonatal carnitine status are needed, including the investigation of participation of carnitine ...

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 49%

Determination of Carnitine Ester Patterns During the Second Half of Pregnancy, at Delivery, and in Neonatal Cord Blood by Tandem Mass Spectrometry: Complex and Dynamic Involvement of Carnitine in the Intermediary Metabolism

et al. 2007

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“…Of the pregnancies, 7/13 were supplemented with carnitine. Patients ingested high doses of carnitine with the same caveats that very little is known about carnitine supplementation in pregnancy (Winter SC et al 1995). The effect of carnitine supplementation on birth parameters needs to be studied further.…”

Section: Discussionmentioning

confidence: 99%

Methylmalonic acidemia (MMA) in pregnancy: a case series and literature review

Raval

Merideth

Sloan

et al. 2015

J of Inher Metab Disea

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Introduction Women with inherited metabolic disorders, including those with previously life-limiting conditions such as MMA, are reaching child-bearing age more often due to advances in early diagnosis and improved pediatric care. Information surrounding maternal and fetal complications associated with the underlying disorders remains largely unexplored. Methods Pregnancies affected by maternal MMA were ascertained through study 04-HG-0127 “Clinical and Basic Investigations of Methylmalonic Acidemia and Related Disorders” (clinicaltrials.gov identifier: NCT00078078) and via literature review. Prenatal and delivery records in study participants were reviewed. Results 17 pregnancies were identified in women with isolated MMA, including 3 abortions, 1 termination, and 13 completed pregnancies [3 cases with cblA (4 pregnancies), 4 cases of mut- (1 cobalamin responsive, 3 non-responsive), 5 cases with unknown type of MMA]. 17% (3/17) of the pregnancies resulted in a first trimester abortion, while 38.5% (5/13) of the completed pregnancies resulted in preterm deliveries. A cesarean delivery rate of 53.8% (7/13) was noted among the cohort. Fetal distress or nonreassuring fetal status was the indication for 57% (4/7) cesarean deliveries. One patient was reported to have metabolic crisis as well as episodes of mild hyperammonemia. Malformations or adverse outcomes in the progeny were not observed. Conclusion Although there have been a small number of pregnancies identified in women with MMA, the cumulative results suggest that the majority of pregnancies can be complicated by cesarean delivery and increased risk of prematurity. A pregnancy registry could clarify perinatal complications and define management approaches needed to ensure optimal maternal and fetal outcomes in this growing patient population.

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“…in the present study, as in several previous reports [6][7][8], have been attributed to transplacental transfer of FC to the fetus, which is not capable of producing carnitine. This is attributed to low activity of the enzyme γ-butyrobetaine hydroxylase being about 12% of adult values at birth [15,16]. Although no clinical evidence of carnitine insufficiency in pregnancy has been observed, the possible involvement of the reduced FC in the metabolic changes observed on normal pregnancy cannot be disputed.…”

Section: Discussionmentioning

confidence: 99%

Effect of Gestational Diabetes on Circulating Levels of Maternal and Neonatal Carnitine

Agakidou¹,

Diamanti²,

Papoulidis³

et al. 2013

J Diabetes Metab

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Objectives: Free carnitine is reported to decrease in normal pregnancies whereas data on the effect of gestational diabetes mellitus (GDM) on maternal and offspring carnitine status are lacking. This study aimed to assess changes in carnitine status in mothers with GDM and the offspring. Subjects/methods:Prospective case-control study of 54 pairs of mothers -neonates (27 with GDM and 27 with normal pregnancies) and 26 non-pregnant controls. Serum glucose, lipids, and total fatty acids, blood β-hydroxybutyric acid, and whole blood carnitine were assessed in mothers before labor and neonates at birth. Carnitine was assessed in dried blood-spots on Guthrie paper using Tandem Mass Spectrometry.Results: Compared to the controls, both groups of mothers had lower free carnitine and acylcarnitine and higher triglyceride and fatty acid levels. Compared to their respective maternal group, both groups of neonates had significantly higher free carnitine and acylcarnitine and lower triglyceride and fatty acid levels. Free carnitine and acylcarnitine, were comparable between the two maternal groups, whereas they were significantly higher in neonates of GDM mothers versus healthy neonates. Conclusions:Well controlled GDM does not exacerbate changes in free carnitine, acylcarnitine, and fatty acid levels in pregnant women, albeit it is associated with increased carnitine in the newborn indicating enhanced fatty acid oxidation. The potential association of carnitine changes with macrosomia and long-term consequences in the offspring of GDM needs further investigation. increased in neonates born to mothers with uncomplicated pregnancies [6,11], whereas there are no published data on the effect of GDM on the neonatal carnitine levels. The primary aim of this study was to assess the effect of GDM on maternal and offspring's carnitine levels. In addition, we investigated the possible association between circulating carnitine levels and FA changes in the mothers and their neonates. Effect of Gestational Diabetes on Circulating Levels of Maternal and Subjects and MethodsThis is a prospective case-control study. Participants were recruited among pregnant women who attended the antenatal clinic of the 2 nd Department of Obstetrics and Gynecology of the Aristotle University of Thessaloniki, at the Hippokration General Hospital, during a twoyear period. Eligible for the study were all pregnant women with single pregnancies who had an abnormal glucose tolerance test at 26-28 weeks of gestation and no history of pre-gestational diabetes. An

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Plasma carnitine concentrations in pregnancy, cord blood, and neonates and children

Cited by 22 publications

References 30 publications

Determination of Carnitine Ester Patterns During the Second Half of Pregnancy, at Delivery, and in Neonatal Cord Blood by Tandem Mass Spectrometry: Complex and Dynamic Involvement of Carnitine in the Intermediary Metabolism

Determination of Carnitine Ester Patterns During the Second Half of Pregnancy, at Delivery, and in Neonatal Cord Blood by Tandem Mass Spectrometry: Complex and Dynamic Involvement of Carnitine in the Intermediary Metabolism

Methylmalonic acidemia (MMA) in pregnancy: a case series and literature review

Effect of Gestational Diabetes on Circulating Levels of Maternal and Neonatal Carnitine

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