Preliminary Investigation On The Relationship Between The Maternal Plasma Homocysteine Levels And Fetal Birth Defect

Objective:Through determination the maternal plasma Hcy levels in gestational period that who had gestation fetal malformation,understanding the relationships between the maternal plasma homocysteine levels and fetal birth defect(especially the relationship between the different types of birth defect),discussion the clinical significance in prental screening and prental diagnosis of birth defects;Analysis the correlation of blood plasma Hcy level in maternal and fetal cord,to further explore the directly influence relevant the role of hyperhomocysteinemia appear to fetal teratogenic.Method:51 cases of pregnant women who confirmed gestation fetal malformation by prental diagnosis or after birth were enrolled as case group,in accordance with diferent types of birth defects is subdivided into four groups:congentital heart malformation(A group),neural tube defects(B group),cleft lip and palate(C group) and other malformations except for A,B and C group(D group).Randomly selected 30 pairs of normal ones as controls.Maternal peripher -al blood and fetal cord blood specimens were collected for Hcy measurement by enzymatic cycling assay.Result:①Maternal mean concentrations of plasma Hcy in A,B,C and D groups were 12.22±4.6μmol/L,22.78±7.42μmol/L,11.24±3.42μmol/L,13.44±6.57μmol/L respectively and significantly higher than that in controls 6.87±1.43μmol/L(P=0.000).②Umbilical Hcy values in case was 13.43±6.57μmol/L and significantly higher than that in controls 6.37±2.22μmol/L (t=5.0461,P=0.000).③There were positive correlation of Hcy values between pregnant women and fetals in case and control groups(r=0.8682,P=0.0052;r=0.6337,P=0.0012).④The age,gestatonal and progesterone of gravida in two groups were no significant difference(P＞0.05);Compared with the control group the gravida in case had lower standard of culture,higeher abnormal early pregnancy and preg.ancy complications.⑤The TORCH positive rate and DOWN's screening risk rAte of case gravida were higher than control group,the difference had statistically significant(X~2=9360,P＜0.05;X~2=3.940,P＜0.05).Conclusion:Maternal hyperhomocysteinemia in gestation is a risk factor for fetus birth defects, especially in congenital heart malformations,neural tube defects and congenital cleft lip and palate three types.It suggested that the plasma Hcy can be considered as a indicator of prental screening birth defects,the maternal plasma concentrations of Hcy higher than 9.67μmol/L can be considered as hyperhomocysteinemia and occur birth defects,and then as one of the indications for prenatal diagnosis birth defects.There is positive correlation of Hcy values between maternal and fetus and though determination of maternal Hcy values can predict the levels of Hcy in fetus.