Homocysteine and folate plasma concentrations in mother and baby at delivery after pre-eclamptic or normotensive pregnancy: Influence of parity

Pre-eclampsia affects between 2% and 7% of all pregnant women, contributing to perinatal and maternal morbidity. There are conflicting data on plasma homocysteine and folate in pre-eclampsia, and little about fetal concentrations.ObjectivesFirstly, to compare the concentrations of homocysteine and folate in maternal and paired fetal (umbilical venous) plasma samples from normotensive or pre-eclamptic pregnancies at delivery; secondly, to identify any effect of parity on these concentrations.Study designHospital based cross-sectional study consisting of 24 normotensive and 16 pre-eclamptic pregnant White European women from whom maternal and fetal plasma samples were collected at delivery.Main outcome measuresMaternal and fetal plasma homocysteine and folate concentrations between normotensive and pre-eclamptic pregnancies with varying parity.ResultsThere were no significant differences in either maternal or fetal plasma homocysteine or folate concentrations between normotensive and pre-eclamptic pregnancies, or between homocysteine and folate. In both the normotensive and pre-eclamptic women, plasma folate concentration was higher in paired fetal compared to maternal plasma (P < 0.001 and P = 0.047, respectively). With regards to homocysteine, only the normotensive samples had higher fetal concentrations (P = 0.002). Both maternal and fetal plasma folate concentrations were lower in parous women (P = 0.001 and P = 0.017, respectively), the lowest concentrations being in pre-eclamptic parous women (P = 0.004), but homocysteine concentrations were similar (P > 0.4 for both).ConclusionsThe low plasma folate in parous women is an interesting finding and, when intake is also low, may contribute to adverse pregnancy outcomes, particularly in relation to pre-eclampsia.