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American Journal of Clinical Nutrition, Vol. 87, No. 2, 391-397, February 2008
© 2008 American Society for Nutrition

ORIGINAL RESEARCH COMMUNICATION

Homocysteine concentration, related B vitamins, and betaine in pregnant women recruited to the Seychelles Child Development Study1,2,3

Julie MW Wallace, Maxine P Bonham, JJ Strain, Emeir M Duffy, Paula J Robson, Mary Ward, Helene McNulty, Philip W Davidson, Gary J Myers, Conrad F Shamlaye, Tom W Clarkson, Anne M Molloy, John M Scott and Per M Ueland

1 From the Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, United Kingdom (JMWW, MPB, JJS, EMD, PJR, MW, and HM); the University of Rochester School of Medicine and Dentistry, Rochester, NY (PWD, GJM, and TWC); The Ministry of Health, Victoria, Republic of Seychelles (CFS); the Department of Clinical Medicine (AMM) and School of Biochemistry and Immunology (JMS), Trinity College Dublin, Dublin, Ireland; and the Section for Pharmacology, Institute of Medicine, University of Bergen and Haukeland University Hospital, Bergen, Norway (PMU)

Background: Both folate and betaine are important predictors of total homocysteine (tHcy) during pregnancy. However, studies to date have only been undertaken in populations with Western dietary patterns.

Objective: We investigated the predictors of tHcy in pregnant women recruited in the Seychelles, a population where access to fortified foods is limited and where women habitually consume diets rich in fish, eggs, rice, and fruit.

Design: Pregnant women (n = 226) provided blood samples at enrollment, at week 28 of gestation, and at delivery. Cord blood was obtained from a subset of participants (n = 135).

Results: As in other studies, maternal tHcy was lower during pregnancy than at delivery, whereas folate and vitamin B-12 status declined significantly to delivery. Despite low maternal folate status at delivery (median: 9.0 nmol/L), with 35% of women in the deficient range (serum folate: <6.8 nmol/L), cord blood folate status (median: 40.2 nmol/L) was similar to concentrations reported in Western populations. Folate was a significant predictor of tHcy at all time points (P < 0.001). In contrast with previous studies, betaine was only a significant predictor of maternal tHcy (P < 0.001) when the essential amino acid methionine was low.

Conclusions: The current study reports 2 important findings. First, fetal requirements for folate are paramount, such that cord blood folate status is maintained, even when maternal status is low. Second, betaine is a significant predictor of tHcy in pregnant women with low serum folate and low serum methionine concentrations.

Key Words: Homocysteine • folate • betaine • vitamin B-12 • pregnancy • maternal status






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