International Health News

High homocysteine level linked to poor pregnancy outcome

BERGEN, NORWAY. Elevated blood levels of homocysteine (a sulfur-containing amino acid) has been linked to a significantly higher risk of cardiovascular disease, stroke and heart attacks, and has also been implicated in Raynaud's phenomenon. Researchers at the universities in Bergen and Oslo now report that high homocysteine levels increase the risk of pregnancy complications and infant abnormalities. Their study evaluated 14,492 pregnancies that occurred between 1967 and 1996. The homocysteine levels of the 5883 mothers involved in the pregnancies were measured in 1992 or 1993 at which time the women were between the ages of 40 and 42 years. The researchers found that women with the highest levels of homocysteine (greater than 10.7 micromol/L) had an adjusted risk for preeclampsia (pregnancy-related hypertension) which was 38 per cent higher than the risk among the women with the lowest levels of homocysteine (3.6-7.5 micromol/L). The risk of giving birth to a very low birth weight baby (weight less than 1500 grams) was 101 per cent higher among high homocysteine women and the risk of stillbirth 103 per cent higher. The association between pregnancy complications and homocysteine levels was particularly pronounced when limiting the analysis to births after 1980. In this cohort high homocysteine levels were associated with an almost five-fold increase in the risk of preeclampsia and a doubling of the risk of premature delivery, stillbirth or the birth of a very low birth weight infant. There was also a significant association between the presence of malformations in the baby and high homocysteine levels in the mother. This was particularly pronounced for neural tube defects where a 3.57-fold increase in risk was observed. The researchers also noted that women with high homocysteine levels tended to smoke more, drink more coffee, have lower educational levels, and did not take vitamin supplements. Editor's Note: High homocysteine levels can be safely and effectively reduced by supplementation with folic acid, vitamin B6 and vitamin B12.
Vollset, Stein Emil, et al. Plasma total homocysteine, pregnancy complications, and adverse pregnancy outcomes: the Hordaland Homocysteine Study. American Journal of Clinical Nutrition, Vol. 71, April 2000, pp. 962-68
Picciano, Mary Frances. Is homocysteine a biomarker for identifying women at risk of complications and adverse pregnancy outcomes? American Journal of Clinical Nutrition, Vol. 71, April 2000, pp. 857-58 (editorial)

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