Hyperhomocysteinemia and recurrent early pregnancy loss: a meta-analysis.

Abstract:

OBJECTIVE:To quantify the risk of recurrent early pregnancy loss in the presence of elevated fasting or afterload homocysteine concentrations or homozygosity for the 677C-->T mutation in the methylenetetrahydrofolate reductase (MTHFR) gene (T/T genotype). DESIGN:Case-control studies published between January 1992 and November 1999 were identified with a MEDLINE-search. These studies were combined with a recent case-control study performed by our own research group. SETTING:Academic research environment. PATIENT(S):Studies published in the English language, concerning two or more pregnancy losses before 16 weeks' menstrual age were included. INTERVENTION(S):Meta-analysis of all of the studies included. MAIN OUTCOME MEASURE(S):The number of subjects with and without hyperhomocysteinemia or with the T/T genotype were derived, if necessary the study was supplemented by personal communication with the original authors. RESULT(S):Pooled risk estimates of 2.7 (1.4 to 5.2) and 4.2 (2.0 to 8.8) were calculated for fasting and afterload plasma homocysteine concentrations, respectively. For the MTHFR T/T genotype a pooled risk estimate of 1.4 (1.0 to 2.0) was found. CONCLUSION(S):These data support hyperhomocysteinemia as a risk factor for recurrent early pregnancy loss. Further research should be focused on the pathophysiology of this relationship and on the clinical efficacy of B vitamin supplementation.

journal_name

Fertil Steril

journal_title

Fertility and sterility

authors

Nelen WL,Blom HJ,Steegers EA,den Heijer M,Eskes TK

doi

10.1016/s0015-0282(00)01595-8

keywords:

subject

Has Abstract

pub_date

2000-12-01 00:00:00

pages

1196-9

issue

6

eissn

0015-0282

issn

1556-5653

pii

S0015-0282(00)01595-8

journal_volume

74

pub_type

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