American Journal of Epidemiology Advance Access originally published online on May 2, 2007
American Journal of Epidemiology 2007 166(3):304-312; doi:10.1093/aje/kwm078
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ORIGINAL CONTRIBUTIONS |
Preconception B-Vitamin and Homocysteine Status, Conception, and Early Pregnancy Loss
1 Department of Nutrition, University of Massachusetts Amherst, Amherst, MA
2 Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois, Chicago, IL
3 Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
4 Institute for Biomedicine, Anhui Medical University, Hefei, People's Republic of China
5 Mary Ann and J. Milburn Smith Child Health Research Program, Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL
6 Children's Memorial Hospital and Children's Memorial Research Center, Chicago, IL
Correspondence to Dr. Alayne Ronnenberg, Department of Nutrition, 209 Chenoweth Laboratory, University of Massachusetts, 100 Holdsworth Way, Amherst, MA 01003 (e-mail: ronnenberg{at}comcast.net).
Received for publication April 22, 2004. Accepted for publication February 2, 2007.
Maternal vitamin status contributes to clinical spontaneous abortion, but the role of B-vitamin and homocysteine status in subclinical early pregnancy loss is unknown. Three-hundred sixty-four textile workers from Anqing, China, who conceived at least once during prospective observation (1996–1998), provided daily urine specimens for up to 1 year, and urinary human chorionic gonadatropin was assayed to detect conception and early pregnancy loss. Homocysteine, folate, and vitamins B6 and B12 were measured in preconception plasma. Relative to women in the lowest quartile of vitamin B6, those in the third and fourth quartiles had higher adjusted proportional hazard ratios of conception (hazard ratio (HR) = 2.2, 95% confidence interval (CI): 1.3, 3.4; HR = 1.6, 95% CI: 1.1, 2.3, respectively), and the adjusted odds ratio for early pregnancy loss in conceptive cycles was lower in the fourth quartile (odds ratio = 0.5, 95% CI: 0.3, 1.0). Women with sufficient vitamin B6 had a higher adjusted hazard ratio of conception (HR = 1.4, 95% CI: 1.1, 1.9) and a lower adjusted odds ratio of early pregnancy loss in conceptive cycles (odds ratio = 0.7, 95% CI: 0.4, 1.1) than did women with vitamin B6 deficiency. Poor vitamin B6 status appears to decrease the probability of conception and to contribute to the risk of early pregnancy loss in this population.
China; chorionic gonadatropin; folic acid; homocysteine; nutritional status; pregnancy outcome; vitamin B 6; vitamin B 12
Abbreviations: CI, confidence interval; hCG, human chorionic gonadotropin; HR, hazard ratio; OR, odds ratio; PLP, pyridoxal 5'-phosphate (vitamin B6)
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