Effects of folic acid and vitamin B6 supplementation on women with hyperhomocysteinemia and a history of preeclampsia or fetal growth restriction.
OBJECTIVE
Our purpose was to assess the incidence of hyperhomocysteinemia in patients with a history of preeclampsia or fetal growth restriction, to evaluate the effects of vitamin supplementation on the methionine loading test, and to study the course of subsequent pregnancies in women with hyperhomocysteinemia and a history of preeclampsia or fetal growth restriction.


METHODS
A total of 207 consecutive patients with a history of preeclampsia or fetal growth restriction was tested for hyperhomocysteinemia. Thirty-seven were found to be positive and were treated with folic acid and vitamin B6, and 27 had a second methionine loading test after vitamin supplementation. Fourteen patients became pregnant again while receiving vitamins and aspirin.


RESULTS
All patients who underwent a methionine loading test after vitamin supplementation had a completely normalized methionine loading test. Of the 14 pregnancies in women receiving vitamins and aspirin, 7 were complicated by preeclampsia. Birth weights were 2867 +/- 648 g compared with 1088 +/- 570 g in the previous pregnancies.


CONCLUSIONS
Vitamin B6 and folic acid correct the methionine loading test in patients with hyperhomocysteinemia. Perinatal outcome in patients with a history of preeclampsia or fetal growth restriction and hyperhomocysteinemia appears to be favorable.
Leeda
M
M
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Free University Hospital, Amsterdam, The Netherlands.
Riyazi
N
N
de Vries
J I
JI
Jakobs
C
C
van Geijn
H P
HP
Dekker
G A
GA
D019587:Dietary Supplements; D005260:Female; D005317:Fetal Growth Retardation / Q000517:prevention & control*; D005492:Folic Acid / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008487:Medical History Taking; D008715:Methionine; D011225:Pre-Eclampsia / Q000517:prevention & control*; D011247:Pregnancy; D011736:Pyridoxine / Q000627:therapeutic use*; D018709:Statistics, Nonparametric
D006710:Homocysteine; D005492:Folic Acid; D008715:Methionine; D011736:Pyridoxine