Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, 3015 GD Rotterdam, The Netherlands.
Department of Biostatistics, Erasmus MC, University Medical Center, 3015 GD Rotterdam, The Netherlands.
Nutrients. 2022 Mar 8;14(6):1129. doi: 10.3390/nu14061129.
Homocysteine is a marker for derangements in one-carbon metabolism. Elevated homocysteine may represent a causal link between poor maternal nutrition and impaired embryonic and fetal development. We sought to investigate associations between reference range maternal homocysteine and embryonic and fetal growth. We enrolled 1060 singleton pregnancies (555 natural and 505 in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) pregnancies) from November 2010 to December 2020. Embryonic and fetal body and head growth was assessed throughout pregnancy using three-dimensional ultrasound scans and virtual reality techniques. Homocysteine was negatively associated with first trimester embryonic growth in the included population (crown-rump length B −0.023 mm, 95% CI −0.038,−0.007, p = 0.004, embryonic volume B −0.011 cm3, 95% CI −0.018,−0.004, p = 0.003). After stratification for conception mode, this association remained in IVF/ICSI pregnancies with frozen embryo transfer (crown-rump length B −0.051 mm, 95% CI −0.081,−0.023, p < 0.001, embryonic volume B −0.024 cm3, 95% CI −0.039,−0.009, p = 0.001), but not in IVF/ICSI pregnancies with fresh embryo transfer and natural pregnancies. Homocysteine was not associated with longitudinal measurements of head growth in first trimester, nor with second and third trimester fetal growth. Homocysteine in the highest quartile (7.3−14.9 µmol/L) as opposed to the lowest (2.5−5.2 µmol/L) was associated with reduced birth weight in natural pregnancies only (B −51.98 g, 95% CI −88.13,−15.84, p = 0.005). In conclusion, high maternal homocysteine within the reference range is negatively associated with first trimester embryonic growth and birth weight, and the effects of homocysteine are dependent on conception mode.
同型半胱氨酸是一碳代谢紊乱的标志物。高同型半胱氨酸可能代表不良的母体营养与胚胎和胎儿发育受损之间的因果联系。我们试图研究参考范围内母体同型半胱氨酸与胚胎和胎儿生长之间的关联。我们招募了 1060 例单胎妊娠（555 例自然妊娠和 505 例体外受精/胞浆内精子注射（IVF/ICSI）妊娠），纳入时间为 2010 年 11 月至 2020 年 12 月。使用三维超声扫描和虚拟现实技术，在整个孕期评估胚胎和胎儿的身体和头部生长。同型半胱氨酸与纳入人群的早孕期胚胎生长呈负相关（头臀长 B-0.023mm，95%CI-0.038，-0.007，p=0.004，胚胎体积 B-0.011cm3，95%CI-0.018，-0.004，p=0.003）。按受孕方式分层后，这种关联在冷冻胚胎移植的 IVF/ICSI 妊娠中仍然存在（头臀长 B-0.051mm，95%CI-0.081，-0.023，p<0.001，胚胎体积 B-0.024cm3，95%CI-0.039，-0.009，p=0.001），但在新鲜胚胎移植的 IVF/ICSI 妊娠和自然妊娠中则没有。同型半胱氨酸与早孕期头围的纵向测量值以及中晚期胎儿生长均无关。与最低四分位数（2.5-5.2µmol/L）相比，最高四分位数（7.3-14.9µmol/L）的同型半胱氨酸与自然妊娠的出生体重降低相关（B-51.98g，95%CI-88.13，-15.84，p=0.005）。总之，参考范围内的高母体同型半胱氨酸与早孕期胚胎生长和出生体重呈负相关，同型半胱氨酸的作用取决于受孕方式。
