Maternal periconceptional biochemical and hematological parameters, vitamin profiles and pregnancy outcome

Abstract

Objectives: To evaluate periconceptional maternal biochemical and hematological parameters and vitamin profiles in relation to the risk of early pregnancy loss and birth weight. Design: Prospective longitudinal study. Setting: University Medical Centre Nijmegen, Academic Medical Centre, Amsterdam, Maria and Elisabeth Hospitals, Tilburg, and Catharina Hospital, Eindhoven, The Netherlands. Subjects: A cohort of 240 women recruited before pregnancy. Interventions: Blood samples were taken preconceptional and at 6 and 10 weeks amenorrhea in which the concentrations of hemoglobin, hematocrit, creatinin, uric acid, total protein, serum iron, total iron-binding capacity, ferritin, and the concentrations of retinol, tocopherol, thiamine, riboflavin, pyridoxal-5 0 -phosphate, cobalamin and folate were analyzed. Main outcome measures: Risk of early pregnancy loss and birth weight. Results: The risk of early pregnancy loss increased with increasing prepregnancy weight, and when the periconceptional decline in hematocrit, creatinin and uric acid was less profound (slope: Po0.01). Maternal smoking was negatively associated with birth weight (mean reduction of 183 g, Po0.05). Maternal age and prepregnancy weight were positively associated with birth weight (Po0.01). No significant associations were found between vitamin concentrations and risk of early pregnancy loss or birth weight. Conclusions: Several periconceptional biochemical parameters are significantly associated with early pregnancy loss. The effects of maternal periconceptional health on embryonic development and subsequent pregnancy outcome should be further explored.

Readmission risk and metabolic, biochemical, haematological and clinical indicators of severity in hyperemesis gravidarum

“…This was probably due to pregnancy related lowering of these ranges. 14,15 High haematocrit was defined as ≥ 0.41, high urea as ≥ 3.6 mmol/L, high creatinine as ≥ 63 µmol/L, prolonged hospital stay as ≥ 4 days stay and severe ketonuria as 4+ ketones (100 mg/mL) on qualitative urine dipstick, as these limits identified the top quartile of our subject population for the above parameters. For all other results, our laboratory's normal ranges were used to delineate normal from abnormal values.…”

Relationship of Maternal Folic Acid and Vitamin B12 with birth weight and body proportion of newborn

“…5 Furthermore; the fetus can be affected resulting in still birth, preterm delivery, IUGR, congenital malformation, reduced immunocompetence and abnormal organ development. 6 So nutritional status during pregnancy has a direct influence upon birth weight of newborn and adequate supply of micronutrient is known to be very important in pregnancy. 7 Vitamin B 12 and folic acid are the two important B vitamins which act as a cofactor for the synthesis of DNA and RNA and in numerous methylation reactions.…”

Homocysteine and Folate in Pregnancy

“…The results obtained in many observational studies suggest that low folate intake or low circulating folate increases the risk of preterm delivery and low birth weight (5 ). However, a recent Dutch study on several B vitamins measured before and during pregnancy in healthy, well-nourished women demonstrated no association between the vitamin concentrations and birth weight or risk of early pregnancy loss (6 ). The results from randomized intervention trials with folic acid have been equivocal (5 ).…”