Higher homocysteine concentrations in women undergoing caesarean section under general anesthesia

To determine whether homocysteine, a risk factor for possible endothelial cell dysfunction, procoagulant effects and premature vascular disease but with a potential nutritional role for fetal and neonatal metabolism and development, is elevated in women at time of elective caesarean section with nitrous oxide general anesthesia. Plasma homocysteine levels were measured in 50 consecutive women, 25 of whom undergoing vaginal delivery and 25 elective caesarean section under nitrous oxide general anesthesia, and in the cord plasma of the respective offspring. Mean (+/-standard deviation) plasma homocysteine levels in the women of the caesarean section group were significantly higher than in the women of the vaginal delivery group (9.77+/-2.3 vs. 6.60+/-2.6 micromol/l, respectively; p<0.02). Cord plasma homocysteine levels in the neonates of the caesarean section group were also significantly higher than in the group of neonates vaginally delivered (9.47+/-3.94 and 7.36+/-2.35 micromol/l; p<0.01). Maternal homocysteine levels significantly correlated with cord levels of caesarean and vaginally delivered neonates (r=0.57; p<0.01 and r=0.66; p<0.001, respectively). Homocysteine levels were elevated at time of delivery in women undergoing elective caesarean section in nitrous oxide general anesthesia, and cord levels of corresponding neonates were affected by mode of delivery. Future studies are necessary to identify factors involved in the hyperhomocysteinemia observed in pregnant women at time of delivery by elective caesarean section in general anesthesia.