Preconception homocysteine and B vitamin status and birth outcomes in Chinese women.

摘要

BACKGROUND: The associations between homocysteine, B vitamin status, and pregnancy outcomes have not been examined prospectively. OBJECTIVE: We assessed the associations of preconception homocysteine and B vitamin status with preterm birth and birth of low-birth-weight (LBW) and small-for-gestational-age (SGA) infants in Chinese women. DESIGN: This was a case-control study of women aged 21-34 y. Preterm cases (n = 29) delivered living infants at or =37 wk. LBW cases (n = 33) had infants weighing or =2500 g. SGA cases (n = 65) had infants below the 10th percentile of weight-for-gestational-age; appropriate-for-gestational-age controls (n = 358) had infants above this cutoff. Nonfasting plasma concentrations of homocysteine, folate, and vitamins B-6 and B-12 were measured before conception. RESULTS: Elevated homocysteine (> or =12.4 micro mol/L) was associated with a nearly 4-fold higher risk of preterm birth (OR: 3.6; 95 CI: 1.3, 10.0; P or =258 pmol/L than among vitamin B-12-deficient women (OR: 0.4; 95 CI: 0.2, 0.9; P or =30 nmol/L than among vitamin B-6-deficient women (OR: 0.5; 95 CI: 0.2, 1.2; NS). Folate status was not associated with preterm birth, and homocysteine and B vitamin status were not associated with LBW or SGA status. CONCLUSIONS: Elevated homocysteine and suboptimal vitamin B-12 and B-6 status may increase the risk of preterm birth. These results need to be confirmed in larger prospective studies.