HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Murphy, M. M Articles by Fernandez-Ballart, J. D Search for Related Content PubMed PubMed Citation Articles by Murphy, M. M Articles by Fernandez-Ballart, J. D Agricola Articles by Murphy, M. M Articles by Fernandez-Ballart, J. D

The pregnancy-related decrease in fasting plasma homocysteine is not explained by folic acid supplementation, hemodilution, or a decrease in albumin in a longitudinal study^1,2,3

¹ From the Unit of Preventive Medicine, Rovira i Virgili University, Reus, Spain (MMM and JDF-B); the Biochemistry Department, Trinity College, Dublin (JMS); and the Vitamin Research Unit, Sir Patrick Dunn’s Research Laboratory, St James’ Hospital, Dublin (JMM).

Background: Fasting plasma total homocysteine (tHcy) decreases during pregnancy. Previous reports suggested that this is due to folic acid supplementation, hemodilution, or a decrease in albumin. However, these hypotheses have not been tested in a longitudinal study.

Objective: We investigated the relation between pregnancy-related physiologic changes and tHcy in a group of healthy women who were either unsupplemented or supplemented with folic acid.

Design: In a longitudinal study from preconception throughout pregnancy, we studied 54 unsupplemented women and 39 women who were supplemented with folic acid during the second or third trimester of pregnancy. tHcy, hematocrit, and serum albumin were determined preconceptionally and at 8, 20, and 32 wk of pregnancy.

Results: For the entire group, geometric mean tHcy concentrations at preconception (8.2 µmol/L) were significantly greater (P < 0.001) than those at 8 wk of pregnancy (6.4 µmol/L). When the unsupplemented and supplemented groups were regarded separately, geometric mean tHcy concentrations at preconception were significantly greater than those at 20 (5.22 and 4.18 µmol/L, respectively) and 32 (5.16 and 4.42 µmol/L, respectively) wk of pregnancy (P < 0.001 for both). Mean reductions from preconception concentrations at 8, 20, and 32 wk of pregnancy were significantly greater (P < 0.001) for tHcy (-11.5%, -25.5%, and -24.5%, respectively) than for hematocrit (-1.9%, -4.2%, and -4.3%, respectively) or serum albumin (-1.1%, -9.8%, and -13.4%, respectively). There was no correlation between changes in either hematocrit or serum albumin and changes in tHcy.

Conclusions: This study refutes the previous explanations for the reduction in plasma tHcy known to occur in pregnancy, namely, folic acid supplementation, hemodilution, and a decrease in serum albumin. We suggest that the changes may be endocrine-based.

Key Words: Homocysteine • pregnancy • preconception • folic acid • supplementation • albumin • hematocrit • longitudinal study

This article has been cited by other articles:

				J. C. Boxmeer, R. P.M. Steegers-Theunissen, J. Lindemans, M. F. Wildhagen, E. Martini, E. A.P. Steegers, and N. S. Macklon Homocysteine metabolism in the pre-ovulatory follicle during ovarian stimulation Hum. Reprod., November 1, 2008; 23(11): 2570 - 2576. [Abstract] [Full Text] [PDF]

				J. M. Wallace, M. P Bonham, J. Strain, E. M Duffy, P. J Robson, M. Ward, H. McNulty, P. W Davidson, G. J Myers, C. F Shamlaye, et al. Homocysteine concentration, related B vitamins, and betaine in pregnant women recruited to the Seychelles Child Development Study Am. J. Clinical Nutrition, February 1, 2008; 87(2): 391 - 397. [Abstract] [Full Text] [PDF]

				F. Simard, F. Guay, C. L. Girard, A. Giguere, J.-P. Laforest, and J. J. Matte Effects of concentrations of cyanocobalamin in the gestation diet on some criteria of vitamin B12 metabolism in first-parity sows J Anim Sci, December 1, 2007; 85(12): 3294 - 3302. [Abstract] [Full Text] [PDF]

				M. M. Murphy, A. M. Molloy, P. M. Ueland, J. D. Fernandez-Ballart, J. Schneede, V. Arija, and J. M. Scott Longitudinal Study of the Effect of Pregnancy on Maternal and Fetal Cobalamin Status in Healthy Women and Their Offspring J. Nutr., August 1, 2007; 137(8): 1863 - 1867. [Abstract] [Full Text] [PDF]

				T. Tamura and M. F. Picciano Folate and human reproduction Am. J. Clinical Nutrition, May 1, 2006; 83(5): 993 - 1016. [Abstract] [Full Text] [PDF]

				P. Christian, T. Jiang, S. K Khatry, S. C LeClerq, S. R Shrestha, and K. P West Jr Antenatal supplementation with micronutrients and biochemical indicators of status and subclinical infection in rural Nepal. Am. J. Clinical Nutrition, April 1, 2006; 83(4): 788 - 794. [Abstract] [Full Text] [PDF]

				J.-I. Lee, J.-A Lee, and H.-S. Lim Effect of time of initiation and dose of prenatal iron and folic acid supplementation on iron and folate nutriture of Korean women during pregnancy Am. J. Clinical Nutrition, October 1, 2005; 82(4): 843 - 849. [Abstract] [Full Text] [PDF]

				F. V Velzing-Aarts, P. I Holm, M R. Fokkema, F. P van der Dijs, P. M Ueland, and F. A Muskiet Plasma choline and betaine and their relation to plasma homocysteine in normal pregnancy Am. J. Clinical Nutrition, June 1, 2005; 81(6): 1383 - 1389. [Abstract] [Full Text] [PDF]

				L. H Allen Multiple micronutrients in pregnancy and lactation: an overview Am. J. Clinical Nutrition, May 1, 2005; 81(5): 1206S - 1212S. [Abstract] [Full Text] [PDF]

				V. A. Holmes, J. M.W. Wallace, H. D. Alexander, W. S. Gilmore, I. Bradbury, M. Ward, J. M. Scott, P. McFaul, and H. McNulty Homocysteine Is Lower in the Third Trimester of Pregnancy in Women with Enhanced Folate Status from Continued Folic Acid Supplementation Clin. Chem., March 1, 2005; 51(3): 629 - 634. [Abstract] [Full Text] [PDF]

				C. Koebnick, I. Hoffmann, P. C. Dagnelie, U. A. Heins, S. N. Wickramasinghe, I. D. Ratnayaka, S. Gruendel, J. Lindemans, and C. Leitzmann Long-Term Ovo-Lacto Vegetarian Diet Impairs Vitamin B-12 Status in Pregnant Women J. Nutr., December 1, 2004; 134(12): 3319 - 3326. [Abstract] [Full Text] [PDF]

				P. M. Ueland and S. E. Vollset Homocysteine and Folate in Pregnancy Clin. Chem., August 1, 2004; 50(8): 1293 - 1295. [Full Text] [PDF]

				M. M. Murphy, J. M. Scott, V. Arija, A. M. Molloy, and J. D. Fernandez-Ballart Maternal Homocysteine before Conception and throughout Pregnancy Predicts Fetal Homocysteine and Birth Weight Clin. Chem., August 1, 2004; 50(8): 1406 - 1412. [Abstract] [Full Text] [PDF]

				H. Refsum, A. D. Smith, P. M. Ueland, E. Nexo, R. Clarke, J. McPartlin, C. Johnston, F. Engbaek, J. Schneede, C. McPartlin, et al. Facts and Recommendations about Total Homocysteine Determinations: An Expert Opinion Clin. Chem., January 1, 2004; 50(1): 3 - 32. [Abstract] [Full Text] [PDF]

				L. Brattstrom Pregnancy-related decrease in total plasma homocysteine Am. J. Clinical Nutrition, April 1, 2003; 77(4): 993 - 993. [Full Text] [PDF]

				M. M Murphy, J. D Fernandez-Ballart, and J. M Scott Reply to L Brattstrom Am. J. Clinical Nutrition, April 1, 2003; 77(4): 993 - 994. [Full Text] [PDF]