Daly Sean, Cotter Amanda, Molloy Ann E, Scott John
Coombe Women's Hospital, Dublin, Ireland.
Semin Vasc Med. 2005 May;5(2):190-200. doi: 10.1055/s-2005-872404.
The role of folic acid and homocysteine in pregnancy is becoming clearer. The efforts of many countries to prevent neural tube defects through public awareness of folic acid have been disappointing, but evidence is now emerging that the food fortification programs in the United States and Canada are effective in reducing the numbers of neural tube defects, and there may be additional benefits in terms of other congenital defects such as oral-facial clefts and congenital heart disease. Homocysteine has a significant association with vascular disease in later life, is elevated in preeclampsia, and has been associated with other pregnancy complications such as early pregnancy loss. The data from cohorts of women with a history of preeclampsia during pregnancy indicate that they are at increased risk for cardiovascular and cerebrovascular disease in later life. Elevated homocysteine concentrations may be a common link that accounts for these associations.
叶酸和同型半胱氨酸在孕期所起的作用正变得愈发清晰。许多国家通过提高公众对叶酸的认知来预防神经管缺陷的努力令人失望，但目前有证据表明，美国和加拿大的食品强化计划在减少神经管缺陷数量方面是有效的，而且在诸如唇腭裂和先天性心脏病等其他先天性缺陷方面可能还有额外益处。同型半胱氨酸与晚年的血管疾病有着显著关联，在子痫前期会升高，并且与其他妊娠并发症如早期流产也有关联。有孕期子痫前期病史的女性队列数据表明，她们在晚年患心血管和脑血管疾病的风险增加。同型半胱氨酸浓度升高可能是解释这些关联的一个共同因素。
