Folate Metabolism and Preeclampsia

Abstract

INTRODUCTIONPreeclampsia (PE) is a multisystem disorder of human pregnancy, affecting about 6% of all pregnancies worldwide, and is one of the leading causes of maternal and infant morbidity and mortality. Despite decades of research into the pathogenesis of this complex disease, the underlying mechanisms remain unclear. As a result, the options for prevention and management of PE are limited. In recent years, there has been a growing body of evidence suggesting that folate deficiency is associated with PE, and folic acid supplementation may reduce the risk of developing PE in certain populations. Folate contributes to cell division and growth, and folate metabolism is involved in a large number of physiological and pathophysiological processes in human development. Sufficient supply of folate is therefore particularly important during pregnancy. Nevertheless, the exact mechanisms of folic acid deficiency increasing the risk of developing PE are still unclear. This article reviews what is understood about the aetiology of PE and the relationship between folate metabolism and PE so as to enhance further discussions on the subject. PREECLAMPSIAPreeclampsia, a syndrome characterized clinically by hypertension and proteinuria, is a leading cause of maternal and perinatal morbidity and mortality worldwide. It affects approximately 6% of all pregnancies resulting in about 8.37 million cases worldwide 1-3 .

Association of pre-eclampsia risk with maternal levels of folate, homocysteine and vitamin B12 in Colombia: A case-control study

“…In the last two decades, a number of authors have investigated the effect that maternal concentrations of folate, homocysteine, and vitamin B12 may have on the development of pre-eclampsia [11–12]. Accumulating evidence suggests that hyperhomocysteinemia may be a cause of the endothelial dysfunction provoked by oxidative stress in pre-eclampsia [13–14]. Homocysteine is an intermediate amino acid that is metabolized into cysteine or methionine.…”

“…In the latter, homocysteine requires folate as a co-substrate and vitamin B12 as a cofactor for the function of involved enzymes such as the methionine synthase enzyme [12]. Low levels of folate and vitamin B12 have been linked to higher homocysteine levels in the bloodstream, increasing the risk of pre-eclampsia [14].…”