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Maternal homocysteine and small-for-gestational-age offspring: systematic review and meta-analysis

Marije Hogeveen1, Henk J Blom, Martin den Heijer

  • 1Department of Pediatrics, Radboud University, Nijmegen Medical Center, Netherlands. m.hogeveen@cukz.umcn.nl

The American Journal of Clinical Nutrition
|December 16, 2011
PubMed

Insights

Higher maternal homocysteine (tHcy) levels are linked to an increased risk of delivering small-for-gestational-age (SGA) newborns. This association, while small for individuals, may have population-level significance for birth weight outcomes.

Area of Science:

  • Obstetrics and Gynecology
  • Perinatal Medicine
  • Nutritional Biochemistry

Background:

  • Intrauterine growth retardation leading to small-for-gestational-age (SGA) newborns is linked to adverse neonatal outcomes and long-term health issues.
  • Elevated maternal total homocysteine (tHcy) concentrations are associated with various pregnancy complications and may impact fetal growth.

Purpose of the Study:

  • To systematically review and meta-analyze the association between maternal tHcy levels and birth weight.
  • To quantify the risk of delivering SGA infants in relation to maternal tHcy concentrations.

Main Methods:

  • A comprehensive literature search of English, German, and French publications was conducted using PubMed (1966-2010).
  • Included studies provided data on maternal tHcy, birth weight, and their association.
  • Effect sizes were converted to odds ratios (ORs) for delivering SGA offspring when maternal tHcy exceeded the 90th percentile.

Main Results:

  • The analysis included 19 studies with a total of 21,326 individuals.
  • A pooled analysis revealed a crude OR of 1.25 (95% CI: 1.09, 1.44) for delivering SGA offspring with elevated maternal tHcy.
  • A 1-SD increase in maternal tHcy was associated with a 31 g decrease in birth weight (95% CI: -13, -51 g).

Conclusions:

  • Elevated maternal tHcy concentrations are associated with a modest increase in the risk of SGA newborns.
  • While the individual impact on birth weight may be clinically minor, the effect could be significant at a population level.
  • Further research may elucidate the clinical implications and potential interventions related to maternal tHcy levels.
Abstract

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