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Modifying Levels of Maternal Dietary Folic Acid or Choline to Study the Impact of Deficiencies on Offspring Health Outcomes

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Published on: June 28, 2024

Homocysteine in pregnancy.

Michelle M Murphy¹, Joan D Fernandez-Ballart

¹Unit of Preventive Medicine and Public Health, Faculty of Medicine and Health Sciences, IISPV, Universitat Rovira i Virgili, Tarragona, Spain. michelle.murphy@urv.cat

Advances in Clinical Chemistry

|March 17, 2011

Summary

Fasting plasma total homocysteine (tHcy) is evaluated as a risk factor for reproductive issues. Elevated tHcy is linked to subfertility and birth defects, but evidence for other pregnancy complications remains conflicting.

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Area of Science:

Reproductive Medicine
Biomarkers
Pregnancy Complications

Background:

Fasting plasma total homocysteine (tHcy) levels are influenced by nutritional, lifestyle, and pregnancy-specific physiological factors.
Pregnancy typically leads to a reduction in tHcy by mid-pregnancy due to hemodilution and increased glomerular filtration rate.
Experimental studies show excess homocysteine impairs reproductive and developmental processes.

Purpose of the Study:

To review and evaluate the evidence supporting or refuting fasting plasma total homocysteine (tHcy) as a biomarker/risk factor for reproductive dysfunction.
To assess the role of tHcy in fertility and pregnancy complications from preconception through gestation.

Main Methods:

Systematic review of existing literature on fasting plasma total homocysteine (tHcy) and reproductive function.
Analysis of studies investigating tHcy levels in relation to fertility, pregnancy outcomes, and offspring development.

Main Results:

Elevated tHcy is confirmed as a risk factor for subfertility, congenital developmental defects, preeclampsia, and intrauterine growth retardation.
Conflicting evidence exists regarding tHcy as a risk factor for miscarriage, gestational diabetes, premature rupture of membranes, placental abruption, and Down syndrome in offspring.

Conclusions:

Further prospective, adequately powered studies initiated in preconception or early pregnancy are necessary.
The definitive role of tHcy as a risk factor for various pregnancy complications requires further investigation.