Maternal plasma homocysteine, placenta status and docosahexaenoic acid concentration in erythrocyte phospholipids of the newborn

The enhanced transport of long-chain polyunsaturated fatty acids, in partic ular docosahexaenoic acid (22:6 omega-3) (DHA), to the fetus is a placental function important for adequate membrane phospholipid formation and herewi th decisive for the quality of fetal CNS myelination. A compromised placent al function is correlated with signs of vascular pathology. As elevated pla sma total homocysteine (tHcy) concentrations are considered an independent risk for premature occlusive vascular disease, the influence of maternal pl asma tHcy concentrations on placental function was indirectly studied, dete rmining the DHA content in erythrocyte membrane phospholipids of the newbor n. A total of 60 unselected pregnant women (age range: 21 to 39 years) were investigated at delivery. Gestational age ranged from 26 to 41 weeks. Prio r to delivery a placental ultrasound scan was performed. Complete sets of d ata could be obtained from 43 mothers and their offspring. tHcy concentrati ons were determined in the plasma of cord and maternal blood. The fatty aci d pattern of erythrocyte membrane phospholipids was determined in the mothe rs and their newborns. Z-scores of the birth weights ranged from -3.4 to 2. 1 and of the placental weights from -3.8 to 4.7. The mean maternal plasma t Hcy concentration was 6.29 +/- 3.34 mu mol/l ranging from below our limit o f detection up to 15 mu mol/l. These maternal concentrations were correlate d with those of their infants (r = 0.71; P < 0.0001). The tHcy concentratio ns were significantly higher in mothers with pregnancies complicated by ges tosis or placental calcifications. The Z-scores of birth weights as well as placental weights showed a significant negative correlation with maternal plasma tHcy concentrations, The mean DHA percentage of total fatty acids in erythrocyte phospholipids was 3.2 +/- 2.2% in the mothers and 3.4 +/- 2.3% in their newborns. Most importantly the maternal plasma tHcy levels and th e erythrocyte phospholipid DHA concentrations of their offspring were signi ficantly correlated (r = -0.51;P < 0.0003). Conclusion In this study, total homocysteine concentrations were elevated i n the plasma of pregnant women with signs of placental vasculopathy. Matern al plasma total homocysteine concentrations were positively correlated with erythrocyte phospholipid docosahexaenoic acid of their offspring and may b e an indicator for the integrity of placental vascular function. The nutrit ional status as well as predisposing genetic factors of pregnant mothers ne ed to be investigated more thoroughly.