title: Moderately elevated maternal homocysteine at preconception is inversely associated with cognitive performance in children 4  months and 6  years after birth.
abstract: Prenatal methyl donor deficiency leads to homocysteine accumulation in the brain and impaired neurodevelopment in rats. We investigated the effect of moderately elevated preconception fasting total plasma homocysteine (tHcy) on child neurodevelopment in a prospective study of 67 and 76 mother-child pairs at 4 months and 6 years of age, respectively. Fasting blood samples at 2-10 weeks preconception, from the cord (nonfasting) and the mother and child 6 years after birth, were collected. Psychomotor and mental development were assessed at 4 months using the Bayley Scale of Infant Development (BSID) and cognitive development at 6 years using the Wechsler Preschool and Primary Scale of Intelligence (WPPSI). Highest tertile preconception tHcy (≥9.04 µmol/L) was categorized as moderately elevated and low-mid tertile tHcy as normal. Children, born to mothers with moderately elevated compared to normal preconception tHcy, scored lower [mean (95% CI)] in the BSID psychomotor [115 (105, 124) vs. 126 (121, 130), p = 0.03] and mental [101 (93, 109) vs. 113 (107, 119), p = 0.03] development tests. Multiple logistic regression analysis showed that moderately elevated compared to normal preconception tHcy was associated with greater probability, OR (95%CI), of scoring in the lowest tertile for BSID psychomotor development (≤120): 4.0 (1.1, 14.3) and lowest tertiles for WPPSI full (≤111), verbal (≤104) and performance (≤111), intellectual quotient: 6.0 (1.5, 23.7), 3.5 (1.1, 11.2) and 4.1 (1.1, 15.7), respectively. We conclude that moderately elevated preconception tHcy is inversely associated with psychomotor and cognitive development scores in infants and children.
authors.affiliation: Area of Preventive Medicine and Public Health, Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili (URV), IISPV, Reus, Spain.|CIBER (CB06/03) ISCIII, Madrid, Spain.
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Murphy
authors.affiliation: Area of Preventive Medicine and Public Health, Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili (URV), IISPV, Reus, Spain.|CIBER (CB06/03) ISCIII, Madrid, Spain.
authors.forename: Joan D
authors.initials: JD
authors.lastname: Fernandez-Ballart
authors.affiliation: Department of Clinical Medicine, Trinity College, Dublin, Ireland.
authors.forename: Anne M
authors.initials: AM
authors.lastname: Molloy
authors.affiliation: Department of Psychology, URV, Tarragona, Spain.
authors.forename: Josefa
authors.initials: J
authors.lastname: Canals
mesh_terms: D000328:Adult; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D001921:Brain; D002648:Child; D002657:Child Development; D003071:Cognition; D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D005215:Fasting; D005260:Female; D005492:Folic Acid / Q000097:blood; D005500:Follow-Up Studies; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D039382:Maternal Nutritional Physiological Phenomena; D018977:Micronutrients / Q000008:administration & dosage; D011247:Pregnancy; D011295:Prenatal Care; D011297:Prenatal Exposure Delayed Effects / Q000097:blood*; D011446:Prospective Studies; D012959:Socioeconomic Factors; D013030:Spain; D014805:Vitamin B 12 / Q000097:blood
chemical_list: D018977:Micronutrients; D006710:Homocysteine; D005492:Folic Acid; D014805:Vitamin B 12
keywords: cognitive development; homocysteine; preconception; pregnancy
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