Relationships of levels of homocysteine, placental growth factor, folic acid and vitamin B12 in maternal blood and umbilical cord blood and their correlations with fetal growth restriction

Objective To observe the levels of the placenta growth factor(PLGF), the homocysteine(Hcy), the folic acid(Fa) and the Vitamin B12(Vit B12) in the maternal blood and the umbilical cord blood, and study the correlation and the mutual influence on the level of the fetal growth restriction(FGR). Methods The 44 inpatient delivery mothers and their babies were selected from Feb.to Nov.2010 in the Third Affiliated Hospital of Inner Mongolia Medical University, according to the womb age with birth weight percentile, and they were divided into 3 groups: the FGR group, appropriate for gestational age(AGA) group, large for gestational age(LGA) group.The fetal birth weight, height, head circumference, abdominal circumference, placenta weight were measured, and body mass index(BMI) was calculated, neonatal growth status was evaluated, and the delivery method and gender were recorded, and the Hcy, Fa, Vit B12 levels in the maternal blood and the umbilical cord blood were detected by enzyme-linked immunosorbent assay, respectively. Results 1.The Fa, Vit B12 levels in the maternal blood, umbilical cord blood in FGR group were obviously lower than those in the LGA group and AGA group(all P<0.05, 0.01). The Hcy levels in the maternal blood, umbilical cord blood in FGR group were obviously higher than those in the LGA group, AGA group(all P<0.05). The PLGF levels in the maternal blood, umbilical cord blood of FGR group were remarkably lower than those in the LGA group and AGA group(P<0.05, 0.01). In the maternal blood and umbilical cord blood, the Fa, Vit B12 levels, were positively correlated with PLGF(all P<0.001).2.The Hcy level in the maternal blood and umbilical cord blood, were negatively correlated with fetal birth weight, height, head circumference, abdominal circumference, placenta weight, BMI(all P<0.05). In the pregnant women blood Fa level, compared with fetal birth weight, head circumference, abdominal circumference, placenta weight, and BMI, were positively correlated(all P<0.05). In the maternal blood Vit B12 level, compared with fetal birth head circumference, abdominal circumference, and BMI, were positively correlated(all P<0.05). In the maternal blood PLGF level, compared with fetal birth weight, head circumference, abdominal circumfe-rence, BMI, was positively correlated(all P<0.05). By the stepwise multiple regression analysis, screening out the maternal blood Fa, Hcy, the umbilical cord blood Hcy influenced the fetal birth weight obviously, the most influent factor for the placenta weight was the maternal blood Hcy.3.The placenta weight in FGR group was lower than that of the LGA group and AGA group(P<0.001), and in the LGA group, AGA group, fetal birth weight, height, head circumfe-rence, abdominal circumference, BMI, compared with the placenta weight, were positively correlated(all P<0.001). Conclusions 1.Hyperhomocysteinemia may happen during pregnancy for the lack of the Fa and Vit B12, and FGR attacks may be related to the rise of Hcy level.2.In the later period of the pregnant women, the Fa, Vit B12, Hcy levels have the severe influence on the fetal physical condition.3.Placenta weight plays an important role in the fetal growth and development.4.The PLGF hyposecretion of the placenta may be the one of the key links to the pathogenesis of the FGR. Key words: Fetal growth restriction; Homocysteine; Folic acid; Vitamin B12; Placenta growth factor