Evaluation of Serum Homocysteine, Zinc and Vitamin Levels in Pregnant Women

Abstract

Aim: Certain vitamins and trace elements in metabolism of pregnant woman should be sufficient for both maternal health and fetal development. Molecules that negatively affect pregnancy should be well known and precautions should be taken in time against them. Homocysteine is an amino acid composed of methionine that converts into cystathionin or recycled into methionine. The cycle of homocysteine involves vitamins B6 and B12, folic acid and zinc. Homocysteine levels have been shown to increase in vitamin B12 and folic acid deficiency. It has been found that increased homocysteine levels play a role in many conditions such as cardiovascular, renal, and cerebral disorders and apoptosis. Hyperhomocysteinemia has been found to cause adverse effects in pregnancy such as preeclampsia, recurrent pregnancy loss, neural tube defects, intrauterine growth restriction, and fetal demise. Zinc, which is found in the structure of metalloenzymes, is a trace element playing an important role in homeostasis and protecting from oxidative stress as well. It is important in pregnant women, fertilization, fetal growth, and development of immunity. In this study, we aimed to determine the difference between homocysteine, folic acid, zinc, and vitamin B12 levels of pregnant women within the first trimester using and not using any kind of vitamin and/or trace element  supplements.

Material and Method: This study was conducted by screening data of patients applying to Obstetrics Department of Necip Fazıl City Hospital for routine pregnancy follow-up during first trimester between January-December 2020. Study was completed with a total of 60 healthy pregnant women, 30 not using any vitamin supplements (Group I) and 30 using vitamin supplements (Group II). Plasma homocysteine, serum folic acid, vitamin B12 and zinc levels were evaluated in the study.

Results: The serum homocysteine, vitamin B12, folic acid and zinc levels of Group I were found as 13.8 ± 5.2 µmol / L, 308.1 ± 62.6 ng / L, 4.49 ± 2.35 µg / L, and 68.8 ± 30.4 µg / dl, respectively. The serum homocysteine, vitamin B12, folic acid and zinc levels of Group II were found as 8.2 ± 3.5 µmol / L, 351.4 ± 111.4 ng / L, 8.47 ± 2.62 µg / L, and 103.8 ± 43.0 µg / dl, respectively. Homocysteine level of Group I was found statistically significantly higher compared to Group II (p<0.05). A statistically significant decrease was found in serum levels in folic acid, vitamin B12 and zinc of Group I (p <0.05).

Conclusion: As a result, pregnant women are in high-risk group for deficiency of several vitamins and minerals due to rapid fetal growth and development. In this study, we found that serum homocysteine levels, an indicator of oxidative stress, were
increased in pregnant women while serum levels of zinc, vitamin B12 and folic acid were decreased. We think that it is essential in terms of maternal and fetal health to determine serum levels of zinc, vitamin B12, folic acid and homocysteine in pregnant women, and to add those molecules to dietary schedule if lacked.