Homocysteine and folate plasma concentrations in mother and baby at delivery after pre-eclamptic or normotensive pregnancy: Influence of parity

Abstract

Pre-eclampsia affects between 2% and 7% of all pregnant women, contributing to perinatal and maternal morbidity. There are conflicting data on plasma homocysteine and folate in pre-eclampsia, and little about fetal concentrations. Objectives Firstly, to compare the concentrations of homocysteine and folate in maternal and paired fetal (umbilical venous) plasma samples from normotensive or pre-eclamptic pregnancies at delivery; secondly, to identify any effect of parity on these concentrations. Study design Hospital based cross-sectional study consisting of 24 normotensive and 16 pre-eclamptic pregnant White European women from whom maternal and fetal plasma samples were collected at delivery. Main outcome measures Maternal and fetal plasma homocysteine and folate concentrations between normotensive and pre-eclamptic pregnancies with varying parity. Results There were no significant differences in either maternal or fetal plasma homocysteine or folate concentrations between normotensive and pre-eclamptic pregnancies, or between homocysteine and folate. In both the normotensive and pre-eclamptic women, plasma folate concentration was higher in paired fetal compared to maternal plasma ( P < 0.001 and P = 0.047, respectively). With regards to homocysteine, only the normotensive samples had higher fetal concentrations ( P = 0.002). Both maternal and fetal plasma folate concentrations were lower in parous women ( P = 0.001 and P = 0.017, respectively), the lowest concentrations being in pre-eclamptic parous women ( P = 0.004), but homocysteine concentrations were similar ( P > 0.4 for both). Conclusions The low plasma folate in parous women is an interesting finding and, when intake is also low, may contribute to adverse pregnancy outcomes, particularly in relation to pre-eclampsia.