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Maternal periconceptional biochemical and hematological parameters, vitamin profiles and pregnancy outcome
S de Weerd1, R P M Steegers-Theunissen, T M de Boo
1Department of Obstetrics and Gynaecology, Erasmus Medical Centre Rotterdam, The Netherlands.
Objectives:
To evaluate periconceptional maternal biochemical and hematological parameters and vitamin profiles in relation to the risk of early pregnancy loss and birth weight.
Design:
Prospective longitudinal study.
Setting:
University Medical Centre Nijmegen, Academic Medical Centre, Amsterdam, Maria and Elisabeth Hospitals, Tilburg, and Catharina Hospital, Eindhoven, The Netherlands.
Subjects:
A cohort of 240 women recruited before pregnancy.
Interventions:
Blood samples were taken preconceptional and at 6 and 10 weeks amenorrhea in which the concentrations of hemoglobin, hematocrit, creatinin, uric acid, total protein, serum iron, total iron-binding capacity, ferritin, and the concentrations of retinol, tocopherol, thiamine, riboflavin, pyridoxal-5'-phosphate, cobalamin and folate were analyzed.
Main Outcome Measures:
Risk of early pregnancy loss and birth weight.
Results:
The risk of early pregnancy loss increased with increasing prepregnancy weight, and when the periconceptional decline in hematocrit, creatinin and uric acid was less profound (slope: P<0.01). Maternal smoking was negatively associated with birth weight (mean reduction of 183 g, P<0.05). Maternal age and prepregnancy weight were positively associated with birth weight (P<0.01). No significant associations were found between vitamin concentrations and risk of early pregnancy loss or birth weight.
Conclusions:
Several periconceptional biochemical parameters are significantly associated with early pregnancy loss. The effects of maternal periconceptional health on embryonic development and subsequent pregnancy outcome should be further explored.
Sponsorship:
Dutch Prevention fund, grants no. 28.1358 and 28.1006.