Serum homocysteine level and its association with folic acid and vitamin B12 in the third trimester of pregnancies complicated with intrauterine growth restriction.

BACKGROUND: Intrauterine growth restriction (IUGR) is a common diagnosis in obstetrics and carries an increased risk of prenatal mortality and morbidity. It is associated with short and long term negative outcome in fetuses, infants, and children. The aim of the study was the determination of serum homocysteine along with folic acid and vitamin B12 concentration in pregnancies complicated with IUGR (intrauterine growth restriction). METHODS: The study was performed in a group of 180 pregnant subjects in the third trimester. Fasting (overnight, at least 12 hour) blood samples were collected from 150 pregnant patients with IUGR and 30 normal pregnant women. Serum total homocysteine (tHcy), serum folic acid, and serum vitamin B12 levels were measured. RESULTS: Mean serum concentration of total homocysteine in the group of pregnant patients with IUGR was 11.14 +/- 4.05 microM/L whereas in the group of normal pregnant women it was 7.42 +/- 2.93 microM/L. The serum folic acid level in the group of pregnant patients with IUGR was 10.24 +/- 3.91 ng/mL while in the group of normal pregnant women it was 15.20 +/- 3.41 ng/mL. The serum vitamin B12 level in the group of pregnant patients with IUGR was 146.99 +/- 43.51 pg/mL where as in the group of normal pregnant women it was 171.96 +/- 25.75 pg/mL. The differences were statistically significant. CONCLUSIONS: The study revealed that increasing serum homocysteine levels in pregnancies complicated with IUGR were accompanied by decreasing levels of serum folic acid and vitamin B12. Treatment with folic acid and vitamin B12 could improve fetal weight in IUGR pregnant patients with increased homocysteine levels.

Antioxidant status and peroxidative stress in mother and newborn -A pilot study.

Serum antioxidant status and peroxidative stress was estimated in 30 pregnant women, their newborn infants and 25 non-pregnant women. Serum Ascorbic acid, α-tocopherol, retinol & ß-carotene levels were found to be significantly reduced and peroxidative stress was significantly higher in mothers as compared to matched non-pregnant women. Newborn had significantly higher levels of ascorbic acid as compared to their mother but had significantly lower levels of lipid soluble vitamins. The peroxidative stress in newborn was found to be significantly less as compared to their mothers. A positive correlation of ascorbic acid and α-tocopherol levels between mother and newborn reflects that their status in mother does influence the newborn status.

Serum iron, copper and zinc status in maternal and cord blood.

Pregnancy is associated with increased demand of all the nutrients like Iron, Copper, Zinc etc. and deficiency of any of these could affect pregnancy, delivery and out come of pregnancy. With this consideration, the study was conducted on 80 mothers and newborns and 20 age matched control women. Out of 80 mothers, 34 had Iron deficiency anemia and their Hb levels were below 9.0 gm/d(1). Pregnant women had significantly lower Iron and Zinc levels while Copper and Total Iron Binding Capacity (TIBC) were significantly higher (P<0.001). Newborns had significantly elevated Iron and Zinc levels and low levels of Copper and TIBC as compared to their mothers irrespective of Iron deficiency anemia. Micronutrient status of newborn was found to be dependent on their mother's micronutrient status. Besides, results also suggest micronutrient interactions, which are reflected in Iron/Zinc, Iron/Copper and Zinc/Copper ratios. In view of this, there is need for proper, adequate and balanced micronutrient supplementation during pregnancy to affect a healthy outcome.