Methionine synthase (MS) is a cobalamin dependent enzyme that catalyses the remethylation of homocysteine to methionine. The methionine synthase reductase (MSR) maintains adequate levels of methylcob(III)alamin, the activated cofactor for MS. The aim of this study was to investigate the effect of MS A2756G and MSR A66G polymorphisms on total homocysteine (tHcy), S-adenosylmethionine (SAM), S-adenosylhomocysteine (SAH) levels in 390 pregnant women and their 292 newborns, from Sorocaba city, Brazil. Genotypes of two polymorphisms were determined by PCR-RFLP. Pregnant women with MS 2756AA genotype have higher tHcy and lower Cbl levels than those with 2756G alleles. The MMA values were increased in neonates with MS 2756AA genotypes (Table 1). There are no difference between the maternal values of Cbl, serum folate, tHcy, MMA and SAM according to MSR A66G genotypes.The values of SAM were lower in neonates with MSR 66G alleles than those with AA genotypes (Table 2). We conclude that MS 2756AA genotypes are associated with higher tHcy levels in pregnant women and higher MMA levels in neonates. The MSR 66GG genotypes is associated with lower SAM levels in neonates.Table 1- Distribution of geometric means and confidence intervals 95% (CI 95%) and numbers of subjects for maternal and neonatal values of cobalamin (Cbl), serum folate, total homocysteine (tHcy), methymalonic acid (MMA) and S- adenosylmethionine (SAM) according to genotypes for the polymorphism MS A2756G.VariablesGenotypes for MS A2756GStudent t TestAAAG + GGPregnant WomenCbl (pmol/L)139 (133 – 144) 235156 (146 – 166) 129P= 0.001SF (nmol/L)14.3 (13.6 – 15.0) 23414.5 (13.6 – 15.5) 129P= 0.667tHcy( μmol/L)6.8 (6.5 – 7.1) 2356.2 (5.9 – 6.6) 128P= 0.036MMA(nmol/L)234 (219 – 245) 194241 (219 – 265) 106P= 0.610SAM(nmol/L)81.8 (77.9 – 86,0) 22983.1 (79.1 – 87.4) 124P= 0.663NeonatesCbl (pmol/L)227 (212 – 244) 188234 (213 – 257) 101P= 0.646SF (nmol/L)32.0 (31.0 – 33.0) 18632.0 (30.8 – 33.2) 99P= 0.967tHcy μmol/L)5.8 (5.5 – 6.1) 1855.5 (5.1 – 5.9) 100P= 0.229MMA(nmol/L)383 (364 – 402) 183342 (317 – 369) 100P= 0.011SAM(nmol/L)188 (181 – 196) 178182 (168 – 197) 98P= 0.491Table 2 - Distribution of geometric means and confidence intervals 95% (CI (%%) and number of subjects for neonatal values of cobalamin (Cbl), serum folate, total homocysteine (tHcy), methylmalonic acid (MMA) and S- adenosylmethionine (SAM) according to genotypes for the polymorphism MSR A66G.VariablesGenotypes MSR A66GStudent t TestAAAGGGNeonatesCbl (pmol/L)225 (202 – 249) 86229 (214 – 246) 166247 (205 – 298) 35P= 0.602SF (nmol/L)33.0 (31.6 – 34.4) 8431.7 (30.7 – 32.7) 16631.8 (29.7 – 34.2) 33P= 0.352tHcy μmol/L) (5.7 (5.3 – 6.2) 845.6 (5.3 – 5.9) 1655.9 (5.3 – 6.6) 34P= 0.618MMA (nmol/L)360 (334 – 389) 84378 (357 – 400) 163339 (299 – 384) 34P= 0.230SAM (nmol/L)200 (186 – 215)a 82184 (176 – 192)a 159170 (149 – 195)b 33P= 0.032Groups not sharing a common superscript letter are significantly different at P<0.05 based on Tukey's test