Abnormal folate metabolism as a risk factor for first-trimester spontaneous abortion.
OBJECTIVE
To assess the potential role of folic acid in early pregnancy loss by measuring homocysteine (hcy) levels in healthy, pregnant women who present with a current first-trimester miscarriage.


METHODS
This was a cross-sectional analysis comprising 13 patients aged 18-31 years old who had a scheduled dilatation and curettage for a first-trimester miscarriage. The controls were 15 patients of similar maternal age presenting for a first-trimester prenatal care visit. Following completion of a 21-item, structured questionnaire, patients were excluded from the study if they had any known risk factors for a first-trimester miscarriage. The remaining patients provided blood samples for measurement of homocysteine and red blood cell folate. Cases and controls were compared using a standard 2-sample t test. In order to detect a clinically relevant 2.3 micromol/L difference in homocysteine levels, 11 cases and 8 controls were needed.


RESULTS
The mean hcy level in cases (5.8 umolmol/L) vs. controls (5.7 micromol/L) was not significantly different (p = 0.83), and all individual values fell within the normal range expected in pregnant women. Red blood cell folate levels (cases=586 ng/mL, controls=611 ng/mL) were also not significantly different (p = 0.72), and no cases of folate deficiency were detected. Maternal age (cases=26, controls=25) and gestational age (cases = 8.8 weeks, controls = 8.4 weeks) were similar between the 2 groups.


CONCLUSIONS
In this community-based pilot study, abnormal folate metabolism was not an apparent risk factor for spontaneous first-trimester pregnancy loss.
Hoffman
Michael L
ML
Department of Obstetrics and Gynecology, University of Illinois Medical Center at Chicago, USA. hoffman1959@yahoo.com
Scoccia
Bert
B
Kurczynski
Thaddeus W
TW
Shulman
Lee P
LP
Gao
Weihua
W
D000022:Abortion, Spontaneous / Q000453:epidemiology* / Q000209:etiology; D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D005260:Female; D005492:Folic Acid / Q000097:blood / Q000378:metabolism*; D005494:Folic Acid Deficiency / Q000097:blood / Q000150:complications*; D005865:Gestational Age; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D010865:Pilot Projects; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D012307:Risk Factors
D006710:Homocysteine; D005492:Folic Acid