| MTHFR and MTRR are key enzymes in folate metabolism,mutations in the gene type leads to a decrease in enzyme activity,thereby affecting folate metabolism,lead to all kinds of adverse pregnancy outcomes: habitual abortion,premature birth,embryo,neural tube defects,fetal chromosomal abnormalities,congenital heart disease,such as cleft lip and palate.People can only through the intestinal absorption of exogenous folic acid and can not synthesize folic acid.Folic acid deficiency in the population can lead to an increased incidence of adverse pregnancy outcomes.Folic acid intake and genotype affect pregnancy outcomes.Different genotypes had different effects on the outcome of pregnancy.Different folate acid supplement an also improve the effect of congenital genotype.ObjectiveTo explore the effects of folic acid metabolism key enzyme methlenetetrahydro folate reductase(MTHFR)gene C677 T,A1298 polymorphism,methionine synthase reductase(MTRR)gene A66 G polymorphism and folic acid supplement and adverse pregnancy history.Methods512 cases of pregnant women who were treated in the outpatient department of the third affiliated hospital of zhengzhou university from September 2014 to 2016 were enrolled in the study.The risk of folic acid was evaluated.First,according to the patient’s history of pregnancy and thistime pregnancy outcome,were divided,including a history of adverse pregnancy(include thistime pregnancy outcome)and 152 cases of abnormal pregnancy group.Selected 360 cases of normal pregnant women as control group.Two patients with oral folic acid,according to the situation,the patients were divided into pre supplemented group,pregnancy without supplementation group.According to the patients with oral folic acid time,divided into the following categories: No supplement,Pre pregnancy supplement,early pregnancy supplement.Through the detection of the polymorphism of adverse pregnancy history of pregnant women and no adverse pregnancy history by MTHFR gene C677 T and maternal A1298 C sites and MTRR A66 G gene analysis,the distribution characteristics of gene polymorphism,and explore their relationship with adverse pregnancy.(1)The obtained through the questionnaire study pregnancy folic acid intake,respectively discuss the pre oral folic acid and pregnant women taking folic acid timing and relationship with the history of abnormal pregnancy.(2)The effect of genotype and oral folic acid on the supplement of folic acid in pregnant women with different genotypes.(3)To explore the regimen of folic acid supplementation in different genotypes by genotype polymorphism and complementation of folic acid.(4)follow-up of this pregnancy outcome,to explore the women who had the past abnormal pregnancy outcome and had not occurred in the past pregnancy,to compare the outcome of two group.Results1.adverse pregnancy history group MTHFR gene 677 TT,1298CC genotype frequency was higher than the control group(P < 0.05);abnormal pregnancy group MTRR 66 gene of wild-type AA genotype frequency was lower than that in normal pregnant women group(P < 0.05),type AG,type GG frequency is higher than the normal pregnant women group(P < 0.05).The history of abnormal pregnancy group compared with normal pregnant women group,did not find the risk ratio is lower than the normal group(P < 0.05);high risk ratio is higher than the normal group(P < 0.05).The ratio of folate metabolism to high risk of adverse pregnancy history is greater than the risk of not found.2.for folic acid supplementation before pregnancy,adverse pregnancy history of pregnant women was higher than normal pregnant women without folic acid supplementation in pregnancy without folic acid proportion,the difference was statistically significant(P < 0.05).To start taking folic acid time,adverse pregnancy history group were higher than the normal group without supplement supplement of folic acid(P < 0.05).The history of abnormal pregnancy group began oral folic acid from pre pregnancy pregnant women ratio is less than the normal group(P < 0.05).3.in pregnancy without folic acid supplementation of pregnant women as the research object,the MTHFR677 TT genotype of adverse pregnancy history group were higher than those in normal group(P < 0.05);pre pregnancy folic acid supplementation to pregnant women as the research object,no significant difference between the two groups of pregnant women,the frequency of TT genotype.Found that the genotype of MTHFR677 TT was pregnant women should be in folic acid before pregnancy.4.in pregnancy without folic acid supplementation of pregnant women as the research object,the MTRR66 AA genotype of adverse pregnancy history group was lower than normal pregnant women(P < 0.05),MTRR66 GG genotype adverse pregnancy history group were higher than those in normal pregnant women(P < 0.05).Genotype MTRR66 AA was the protective factor of pregnancy,genotype MTRR66 GG should be in pre pregnancy folic acid supplement.ConclusionsAdverse pregnancy was associated with MTHFR and MTRR gene polymorphism.Folate deficiency during pregnancy,pregnancy without risk of adverse pregnancy folic acid supplementation increased.Genetic analysis showed MTHFR677 TT,MTRR66GG genotype of pregnant women should be more adequate folic acid. |
PDF Full Text Request