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Low ratio of S-adenosylmethionine to S-adenosylhomocysteine is associated with vitamin deficiency in Brazilian pregnant women and newborns^1,2,3

¹ From the Departamento de Análises Clínicas e Toxicológicas, Faculdade de Ciências Farmacêuticas da Universidade de São Paulo, São Paulo, Brazil (EMGS and SP); Programa de Pós-Graduação da Coordenadoria dos Institutos de Pesquisas da Secretaria de Saúde do Estado de São Paulo, São Paulo, Brazil (OEM); Instituto Adolfo Lutz, Laboratório de São José do Rio Preto, São José do Rio Preto, Brazil (RAP); Faculdade de Medicina, Pontificia Universidade Católica de Sao Paulo, São Paulo, Brazil (LFSN); Departamento de Pediatria, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil (VDA); Serviço de Patologia Clínica do Conjunto Hospitalar de Sorocaba, Secretaria da Saúde do Estado de São Paulo, São Paulo, Brazil (SPI); and the Department of Medicine, University of Colorado Health Sciences Center, Denver (RHA and SPS)

Background: Pregnant women with low cobalamin concentrations are unable to provide the necessary amount of cobalamin to their fetuses. The effect of low maternal cobalamin concentrations on transmethylation metabolism in pregnant women and their newborns is unknown.

Objective: We investigated the relation between maternal and neonatal cobalamin concentrations and changes in total homocysteine (tHcy), S-adenosylmethionine (SAM), and S-adenosylhomocysteine (SAH).

Design: Hematologic data and concentrations of cobalamin, red blood cell folate, serum folate, tHcy, methylmalonic acid, SAM, SAH, and other metabolites were measured in 119 serum specimens from pregnant Brazilian women (gestational age: 37–42 wk) and their newborns' placental veins at the time of delivery.

Results: The tHcy concentrations were higher in placental vein serum from newborns whose mothers had low cobalamin. Serum SAH concentrations were elevated and serum SAM and methionine concentrations were decreased in pregnant women with lower cobalamin concentrations. SAM:SAH was significantly decreased in both cobalamin-deficient pregnant women and their newborns.

Conclusions: Lower maternal cobalamin concentrations are associated with higher tHcy and lower SAM:SAH in newborns. Because SAM:SAH is closely linked with the activity of numerous enzymatic methylation reactions, these results suggest that methylation could be impaired in cobalamin-deficient pregnant women and their newborns.

Key Words: Cobalamin • folate • homocysteine • methylmalonic acid • S-adenosylhomocysteine • S-adenosylmethionine • pregnant women • newborns

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