Physiologic changes in homocysteine metabolism in pregnancy: A longitudinal study in Spain

Úbeda, Natalia; Reyes, Leticia; González-Medina, Antonio; Alonso-Aperte, Elena; Varela‐Moreiras, Gregorio

doi:10.1016/j.nut.2010.10.017

Cited by 35 publications

(29 citation statements)

References 52 publications

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“…Individuals with the TT genotype have increased dietary folate requirements because they have lower RBC folate levels compared with those without this genetic variant, and the increase in tHcy is found mostly in patients with folate deficiency. However, in our study, mean RBC folate level and mean plasma concentration of Hcy did not vary significantly by genotype, and no correlation between folate intake and circulating levels stratified by genotype were found, also considering pregnancy and smoking status, confirming previous results reported in the general population [30], in women of childbearing age [31] and in folic acid-supplemented pregnant women [8]. Nevertheless, our results should be interpreted with caution due to the small number of women studied.…”

Section: Discussionsupporting

confidence: 90%

“…Besides, in our study, subjects who reported consuming folic acid supplements had a significantly higher mean RBC folate level and a significantly lower plasma concentration of tHcy than those who did not take supplements, showing that folic acid supplementation increases blood folate and decreases Hcy concentrations [8]. Despite supplementation, the optimal level of folate required to prevent NTD was never reached, as this would depend on the elimination kinetics of folate in RBCs and on the various forms, doses and duration of daily supplementation [22].…”

Section: Discussionmentioning

confidence: 77%

“…Blood folate levels are directly correlated with intake and, when low, are not only associated with NTDs but also with megaloblastic anemia and high blood Hcy levels [6]. Maternal total Hcy (tHcy) concentrations have been linked to a wide range of adverse pregnancy outcomes, including growth retardation in utero [7], preeclampsia, abruptio placentae, low birth weight, and other maternal or fetal complications [8]. Plasma Hcy levels are determined by both dietary and genetic factors, namely the common polymorphism for the gene that encodes the methylene tetrahydrofolate reductase (MTHFR) enzyme, the MTHFR 677 C to T polymorphism.…”

Section: Introductionmentioning

confidence: 99%

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Dietary Folate Intake and Blood Biomarkers Reveal High-Risk Groups in a Mediterranean Population of Healthy Women of Childbearing Potential

et al. 2013

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Background/Aims: An important public health issue is monitoring folate inadequacy in women of childbearing potential. The aim of the present study was to investigate associations between folate intake, red blood cell (RBC) folate, total homocysteine (tHcy) and the MTHFR 677T allele. Methods: A total of 204 women were enrolled in a cross-sectional study. Folate intake was assessed by a food frequency questionnaire, and RBC folate, tHcy and MTHFR C677T genotype were determined. Results: About half of the women had a decreased RBC folate level (<305 nmol/l) and all were <906 nmol/l, even though 51% of the subjects reported use of supplements. Overall 91.5% had a high Hcy concentration. Notably, younger women, and those with a low level of education, were shown to be at higher risk of inadequate RBC folate levels. Additionally, younger women were also at higher risk of carrying the TT genotype, particularly unfavorable in the setting of a low folate status. Conclusions: Our study revealed significant folate deficiency in our Mediterranean population and higher than ideal Hcy concentrations, thus emphasizing that in these groups an improvement in the folate status is needed via a food-based approach or supplement. Consequently, public health policy strategies aiming at improved supplementation are required.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 77%

Section: Introductionmentioning

confidence: 99%

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Dietary Folate Intake and Blood Biomarkers Reveal High-Risk Groups in a Mediterranean Population of Healthy Women of Childbearing Potential

et al. 2013

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“…Because the heterogeneity between the studies was high and there were differences in the populations and vitamin B-12 assays, it was not possible to make meaningful conclusions with regard to a vitamin B-12 "threshold" that would be associated with lower fetal BW. In the 2 studies that reported results from .1 trimester (25,115), the difference in maternal vitamin B-12 between normal-BW and LBW infants was greater in the first or second trimester than in the third trimester (233 compared with 221 pmol/L and 224 compared with 219 pmol/L, respectively), suggesting that lower vitamin B-12 status earlier in pregnancy may be more detrimental for offspring weight.…”

Section: Vitamin B-12 Insufficiency and Bwmentioning

confidence: 99%

Prevalence of vitamin B-12 insufficiency during pregnancy and its effect on offspring birth weight: a systematic review and meta-analysis

Sukumar

Rafnsson

Kandala

et al. 2016

The American Journal of Clinical Nutrition

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Background: Vitamin B-12 and folate are micronutrients essential for normal embryogenesis. Vitamin B-12 insufficiency in pregnancy is high in certain parts of the world, such as India, and although this has been linked to low birth weight (LBW) in these populations, the relation between vitamin B-12 and birth weight (BW) elsewhere is unknown. Objectives: We performed a systematic review to assess 1) the worldwide prevalence of vitamin B-12 insufficiency in pregnancy and 2) its association with BW. Design: A search of 5 electronic databases was performed to identify eligible articles. Random-effects meta-analysis was conducted according to geographic regions and pregnancy trimesters for the prevalence subreview and by categorical measures of BW. Results: A total of 57 and 23 articles were included for the prevalence and BW subreviews, respectively. The pooled estimates of vitamin B-12 insufficiency were 21%, 19%, and 29% in the first, second, and third trimesters, respectively, with high rates for the Indian subcontinent and the Eastern Mediterranean. The large heterogeneity between studies was partially addressed by creating a standardized score for each study (mean vitamin B-12 insufficiency O cutoff value), which internally corrected for geographic region, trimester, and assay type. Twelve of the 13 longitudinal studies included showed a decrease in mean or median vitamin B-12 across trimesters. Pooled analysis showed nonsignificantly lower maternal vitamin B-12 concentrations in LBW than in normal-BW infants and higher odds of LBW with lower vitamin B-12 values (adjusted OR: 1.70; 95% CI: 1.16, 2.50), but studies from India largely contributed to the latter. Conclusions: Our review indicates that vitamin B-12 insufficiency during pregnancy is common even in nonvegetarian populations and that concentrations of vitamin B-12 decrease from the first to the third trimester. There is no consistent association between vitamin B-12 insufficiency and LBW. However, given the long-term risks of LBW, this observation warrants further cohort studies and randomized controlled trials.Am J Clin Nutr 2016;103:1232-51.

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“…11,51 Discordant findings could also be due to differences in the gestational age at folate measurement; maternal folate concentrations measured in peripheral blood decrease with increasing gestational age, as folate demands increase during fetal growth and development. 52 The majority of studies with null findings collected blood specimens during the second or third trimester. In our analysis, restricted to 326 infant-mother pairs in whom maternal specimens were collected at gestational age < 12 wk, the magnitude of associations was somewhat higher than when all women were included.…”

Section: Discussionmentioning

confidence: 99%

Erythrocyte folate concentrations, CpG methylation at genomically imprinted domains, and birth weight in a multiethnic newborn cohort

et al. 2014

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Physiologic changes in homocysteine metabolism in pregnancy: A longitudinal study in Spain

Cited by 35 publications

References 52 publications

Dietary Folate Intake and Blood Biomarkers Reveal High-Risk Groups in a Mediterranean Population of Healthy Women of Childbearing Potential

Dietary Folate Intake and Blood Biomarkers Reveal High-Risk Groups in a Mediterranean Population of Healthy Women of Childbearing Potential

Prevalence of vitamin B-12 insufficiency during pregnancy and its effect on offspring birth weight: a systematic review and meta-analysis

Erythrocyte folate concentrations, CpG methylation at genomically imprinted domains, and birth weight in a multiethnic newborn cohort

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