Department of Gynecology and Obstetrics, University of Health Sciences, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Türkiye.
Medicine (Baltimore). 2024 Aug 9;103(32):e39101. doi: 10.1097/MD.0000000000039101.
A disturbance in the metabolism of homocysteine in both the mother and the fetus has been implicated in several placental vasculopathy-related disorders, including pregnancy loss. This study aimed to provide insights into the potential role of homocysteine, Vitamin B12, and folic acid in early pregnancy losses, with a specific focus on the Turkish population. The results of 93 pregnant women who experienced miscarriage between 5 and 14 gestational weeks and 93 healthy pregnant women at the same gestational weeks were compared. The demographic and pregnancy characteristics of all pregnant women were recorded. Vitamin B12, folic acid, and homocysteine levels were measured in serum samples obtained from the groups at similar gestational weeks. In addition, any associations between these biomarkers and different types of pregnancy loss, such as spontaneous abortion and missed abortion, were evaluated. Vitamin B12 and folic acid serum levels were significantly lower in women with miscarriages (P = .019, P < .001, respectively). Homocysteine levels were higher in the patient group (P < .001). Logistic regression analysis showed that a higher homocysteine level was the only predictive factor of miscarriage (P = .001, odds ratio = 0.596); however, folic acid and Vitamin B12 were not predictive factors. There was no significant difference in homocysteine and micronutrient levels between women with missed abortions and women with spontaneous abortions (P > .05). Our results support the continuing evidence of a link between maternal homocysteine levels and fetal loss. However, in exploring the shared pathways in the underlying mechanisms causing the 2 forms of pregnancy loss, maternal blood analysis showed no relationship.
母体和胎儿中同型半胱氨酸代谢紊乱与几种胎盘血管病变相关疾病有关,包括妊娠丢失。本研究旨在深入了解同型半胱氨酸、维生素 B12 和叶酸在早期妊娠丢失中的潜在作用,特别关注土耳其人群。比较了 93 名在 5 至 14 孕周经历自然流产的孕妇和 93 名同期健康孕妇的结果。记录了所有孕妇的人口统计学和妊娠特征。在相似孕周时,从各组采集血清样本以测量维生素 B12、叶酸和同型半胱氨酸水平。此外,评估了这些生物标志物与不同类型妊娠丢失(如自然流产和稽留流产)之间的任何关联。流产组的维生素 B12 和叶酸血清水平显著降低(P=0.019,P<0.001)。患者组的同型半胱氨酸水平较高(P<0.001)。逻辑回归分析表明,较高的同型半胱氨酸水平是流产的唯一预测因素(P=0.001,优势比=0.596);然而,叶酸和维生素 B12 不是预测因素。稽留流产组和自然流产组之间同型半胱氨酸和微量营养素水平无显著差异(P>0.05)。我们的结果支持母体同型半胱氨酸水平与胎儿丢失之间存在联系的持续证据。然而,在探索导致这两种妊娠丢失的潜在机制的共享途径时,母体血液分析未显示出任何关系。