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Original Research Communications |
1 From the Section for Medical Statistics, the Department of Public Health and Primary Health Care; the Department of Pharmacology, and the Medical Birth Registry of Norway, University of Bergen, Bergen; the National Health Screening Service, Oslo; and the Section for Medical Statistics, University of Oslo.
Background: Total homocysteine (tHcy) measured in serum or plasma is a marker of folate status and a risk factor for cardiovascular disease.
Objective: Our objective was to investigate associations between tHcy and complications and adverse outcomes of pregnancy.
Design: Plasma tHcy values measured in 1992–1993 in 5883 women aged 40–42 y were compared with outcomes and complications of 14492 pregnancies in the same women that were reported to the Medical Birth Registry of Norway from 1967 to 1996.
Results: When we compared the upper with the lower quartile of plasma tHcy, the adjusted risk for preeclampsia was 32% higher [odds ratio (OR): 1.32; 95% CI: 0.98, 1.77; P for trend = 0.02], that for prematurity was 38% higher (OR: 1.38; 95% CI: 1.09, 1.75; P for trend = 0.005), and that for very low birth weight was 101% higher (OR: 2.01; 95% CI: 1.23, 3.27; P for trend = 0.003). These associations were stronger during the years closest to the tHcy determination (1980–1996), when there was also a significant relation between tHcy concentration and stillbirth (OR: 2.03; 95% CI: 0.98, 4.21; P for trend = 0.02). Neural tube defects and clubfoot had significant associations with plasma tHcy. Placental abruption had no relation with tHcy quartile, but the adjusted OR when tHcy concentrations >15 µmol/L were compared with lower values was 3.13 (95% CI: 1.63, 6.03; P = 0.001).
Conclusion: Elevated tHcy concentration is associated with common pregnancy complications and adverse pregnancy outcomes.
Key Words: Total homocysteine • folate • pregnancy complications • congenital malformations • observational study • preeclampsia • abruptio placentae • placental abruption • neural tube defects • the Hordaland Homocysteine Study • Norway • whites • tHcy
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M. F. Picciano Is homocysteine a biomarker for identifying women at risk of complications and adverse pregnancy outcomes? Am. J. Clinical Nutrition, April 1, 2000; 71(4): 857 - 858. [Full Text] [PDF]
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