Plasma total homocysteine, pregnancy complications, and adverse pregnancy outcomes: the Hordaland Homocysteine study.
BACKGROUND
Total homocysteine (tHcy) measured in serum or plasma is a marker of folate status and a risk factor for cardiovascular disease.


OBJECTIVE
Our objective was to investigate associations between tHcy and complications and adverse outcomes of pregnancy.


METHODS
Plasma tHcy values measured in 1992-1993 in 5883 women aged 40-42 y were compared with outcomes and complications of 14492 pregnancies in the same women that were reported to the Medical Birth Registry of Norway from 1967 to 1996.


RESULTS
When we compared the upper with the lower quartile of plasma tHcy, the adjusted risk for preeclampsia was 32% higher [odds ratio (OR): 1. 32; 95% CI: 0.98, 1.77; P for trend = 0.02], that for prematurity was 38% higher (OR: 1.38; 95% CI: 1.09, 1.75; P for trend = 0.005), and that for very low birth weight was 101% higher (OR: 2.01; 95% CI: 1.23, 3.27; P for trend = 0.003). These associations were stronger during the years closest to the tHcy determination (1980-1996), when there was also a significant relation between tHcy concentration and stillbirth (OR: 2.03; 95% CI: 0.98, 4.21; P for trend = 0.02). Neural tube defects and clubfoot had significant associations with plasma tHcy. Placental abruption had no relation with tHcy quartile, but the adjusted OR when tHcy concentrations >15 micromol/L were compared with lower values was 3.13 (95% CI: 1.63, 6. 03; P = 0.001).


CONCLUSIONS
Elevated tHcy concentration is associated with common pregnancy complications and adverse pregnancy outcomes.
Vollset
S E
SE
Section for Medical Statistics, the Department of Public Health and Primary Health Care, Norway. stein.vollset@uib.no
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Irgens
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D000037:Abruptio Placentae / Q000097:blood; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D003025:Clubfoot / Q000097:blood; D000013:Congenital Abnormalities / Q000097:blood; D005260:Female; D005313:Fetal Death / Q000097:blood; D005317:Fetal Growth Retardation / Q000097:blood; D005494:Folic Acid Deficiency / Q000097:blood; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008297:Male; D008875:Middle Aged; D009436:Neural Tube Defects / Q000097:blood; D009664:Norway; D007752:Obstetric Labor, Premature / Q000097:blood; D011225:Pre-Eclampsia / Q000097:blood; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood*; D011256:Pregnancy Outcome; D012042:Registries; D012307:Risk Factors
D015415:Biomarkers; D006710:Homocysteine