Homocysteine is lower in the third trimester of pregnancy in women with enhanced folate status from continued folic acid supplementation

VA Holmes, Julie Wallace, HD Alexander, WS Gilmore, I Bradbury, Mary Ward, JM Scott, P McFaul, Helene McNulty

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Abstract

Background: In many countries, current recommendations are that women take a daily 400-mug folic acid supplement from before conception until the end of the 12th week of gestation for the prevention of neural tube defects. Low folate status is associated with an increased concentration of plasma total homocysteine (tHcy), a risk factor associated with pregnancy complications such as preeclampsia. Methods: In a longitudinal study, we determined tHcy and corresponding folate status in 101 pregnant women at 12, 20, and 35 weeks of gestation, in 35 nonpregnant controls sampled concurrently, and in a subgroup (n = 21 pregnant women and 19 nonpregnant controls) at 3 days postpartum. Results: Plasma tHcy was significantly lower throughout pregnancy compared with nonpregnant controls, with values lowest in the second trimester before increasing toward nonpregnant values in the third trimester. Importantly, mean tHcy concentrations were lower in pregnant women taking folic acid supplements than in those not, an effect that reached significance in the third trimester (5.45 vs 7.40 mumol/L; P <0.05). During the third trimester, tHcy concentrations were significantly higher in pregnant women with a history of miscarriage than in women with no previous history (8.15 vs 6.38 &mu;mol/L; P <0.01). Conclusions: This is the first longitudinal study to show that homocysteine concentrations increase in late pregnancy toward nonpregnant values; an increase that can be limited by enhancing folate status through continued folic acid supplementation. These results indicate a potential role for continued folic acid supplementation in reducing pregnancy complications associated with hyperhomocysteinemia. (C) 2005 American Association for Clinical Chemistry.
LanguageEnglish
Pages629-634
JournalClinical Chemistry
Volume51
Issue number3
DOIs
Publication statusPublished - Mar 2005

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Third Pregnancy Trimester
Homocysteine
Folic Acid
Pregnant Women
Pregnancy
Pregnancy Complications
Longitudinal Studies
Hyperhomocysteinemia
Neural Tube Defects
Second Pregnancy Trimester
Spontaneous Abortion
Pre-Eclampsia
Postpartum Period

Cite this

Holmes, VA ; Wallace, Julie ; Alexander, HD ; Gilmore, WS ; Bradbury, I ; Ward, Mary ; Scott, JM ; McFaul, P ; McNulty, Helene. / Homocysteine is lower in the third trimester of pregnancy in women with enhanced folate status from continued folic acid supplementation. In: Clinical Chemistry. 2005 ; Vol. 51, No. 3. pp. 629-634.
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abstract = "Background: In many countries, current recommendations are that women take a daily 400-mug folic acid supplement from before conception until the end of the 12th week of gestation for the prevention of neural tube defects. Low folate status is associated with an increased concentration of plasma total homocysteine (tHcy), a risk factor associated with pregnancy complications such as preeclampsia. Methods: In a longitudinal study, we determined tHcy and corresponding folate status in 101 pregnant women at 12, 20, and 35 weeks of gestation, in 35 nonpregnant controls sampled concurrently, and in a subgroup (n = 21 pregnant women and 19 nonpregnant controls) at 3 days postpartum. Results: Plasma tHcy was significantly lower throughout pregnancy compared with nonpregnant controls, with values lowest in the second trimester before increasing toward nonpregnant values in the third trimester. Importantly, mean tHcy concentrations were lower in pregnant women taking folic acid supplements than in those not, an effect that reached significance in the third trimester (5.45 vs 7.40 mumol/L; P <0.05). During the third trimester, tHcy concentrations were significantly higher in pregnant women with a history of miscarriage than in women with no previous history (8.15 vs 6.38 &mu;mol/L; P <0.01). Conclusions: This is the first longitudinal study to show that homocysteine concentrations increase in late pregnancy toward nonpregnant values; an increase that can be limited by enhancing folate status through continued folic acid supplementation. These results indicate a potential role for continued folic acid supplementation in reducing pregnancy complications associated with hyperhomocysteinemia. (C) 2005 American Association for Clinical Chemistry.",
author = "VA Holmes and Julie Wallace and HD Alexander and WS Gilmore and I Bradbury and Mary Ward and JM Scott and P McFaul and Helene McNulty",
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Homocysteine is lower in the third trimester of pregnancy in women with enhanced folate status from continued folic acid supplementation. / Holmes, VA; Wallace, Julie; Alexander, HD; Gilmore, WS; Bradbury, I; Ward, Mary; Scott, JM; McFaul, P; McNulty, Helene.

In: Clinical Chemistry, Vol. 51, No. 3, 03.2005, p. 629-634.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Homocysteine is lower in the third trimester of pregnancy in women with enhanced folate status from continued folic acid supplementation

AU - Holmes, VA

AU - Wallace, Julie

AU - Alexander, HD

AU - Gilmore, WS

AU - Bradbury, I

AU - Ward, Mary

AU - Scott, JM

AU - McFaul, P

AU - McNulty, Helene

PY - 2005/3

Y1 - 2005/3

N2 - Background: In many countries, current recommendations are that women take a daily 400-mug folic acid supplement from before conception until the end of the 12th week of gestation for the prevention of neural tube defects. Low folate status is associated with an increased concentration of plasma total homocysteine (tHcy), a risk factor associated with pregnancy complications such as preeclampsia. Methods: In a longitudinal study, we determined tHcy and corresponding folate status in 101 pregnant women at 12, 20, and 35 weeks of gestation, in 35 nonpregnant controls sampled concurrently, and in a subgroup (n = 21 pregnant women and 19 nonpregnant controls) at 3 days postpartum. Results: Plasma tHcy was significantly lower throughout pregnancy compared with nonpregnant controls, with values lowest in the second trimester before increasing toward nonpregnant values in the third trimester. Importantly, mean tHcy concentrations were lower in pregnant women taking folic acid supplements than in those not, an effect that reached significance in the third trimester (5.45 vs 7.40 mumol/L; P <0.05). During the third trimester, tHcy concentrations were significantly higher in pregnant women with a history of miscarriage than in women with no previous history (8.15 vs 6.38 &mu;mol/L; P <0.01). Conclusions: This is the first longitudinal study to show that homocysteine concentrations increase in late pregnancy toward nonpregnant values; an increase that can be limited by enhancing folate status through continued folic acid supplementation. These results indicate a potential role for continued folic acid supplementation in reducing pregnancy complications associated with hyperhomocysteinemia. (C) 2005 American Association for Clinical Chemistry.

AB - Background: In many countries, current recommendations are that women take a daily 400-mug folic acid supplement from before conception until the end of the 12th week of gestation for the prevention of neural tube defects. Low folate status is associated with an increased concentration of plasma total homocysteine (tHcy), a risk factor associated with pregnancy complications such as preeclampsia. Methods: In a longitudinal study, we determined tHcy and corresponding folate status in 101 pregnant women at 12, 20, and 35 weeks of gestation, in 35 nonpregnant controls sampled concurrently, and in a subgroup (n = 21 pregnant women and 19 nonpregnant controls) at 3 days postpartum. Results: Plasma tHcy was significantly lower throughout pregnancy compared with nonpregnant controls, with values lowest in the second trimester before increasing toward nonpregnant values in the third trimester. Importantly, mean tHcy concentrations were lower in pregnant women taking folic acid supplements than in those not, an effect that reached significance in the third trimester (5.45 vs 7.40 mumol/L; P <0.05). During the third trimester, tHcy concentrations were significantly higher in pregnant women with a history of miscarriage than in women with no previous history (8.15 vs 6.38 &mu;mol/L; P <0.01). Conclusions: This is the first longitudinal study to show that homocysteine concentrations increase in late pregnancy toward nonpregnant values; an increase that can be limited by enhancing folate status through continued folic acid supplementation. These results indicate a potential role for continued folic acid supplementation in reducing pregnancy complications associated with hyperhomocysteinemia. (C) 2005 American Association for Clinical Chemistry.

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DO - 10.1373/clinchem.2004.032698

M3 - Article

VL - 51

SP - 629

EP - 634

JO - Clinical Chemistry

T2 - Clinical Chemistry

JF - Clinical Chemistry

SN - 0009-9147

IS - 3

ER -