EFFECTS OF FOLIC-ACID AND VITAMIN-B-6 SUPPLEMENTATION ON WOMEN WITH HYPERHOMOCYSTEINEMIA AND A HISTORY OF PREECLAMPSIA OR FETAL GROWTH RESTRICTION

OBJECTIVE: Our purpose was to assess the incidence of hyperhomocystein emia in patients with a history of preeclampsia or fetal growth restri ction, to evaluate the effects of vitamin supplementation on the methi onine loading test, and to study the course of subsequent pregnancies in women with hyperhomocysteinemia and a history of preeclampsia or fe tal growth restriction. STUDY DESIGN: A total of 207 consecutive patie nts with a history of preeclampsia or fetal growth restriction was tes ted for hyperhomocysteinemia. Thirty-seven were found to be positive a nd were treated with folic acid and vitamin B-6, and 27 had a second m ethionine loading test after vitamin supplementation. Fourteen patient s became pregnant again while receiving vitamins and aspirin. RESULTS: All patients who underwent a methionine loading test after vitamin su pplementation had a completely normalized methionine loading test. Of the 14 pregnancies in women receiving vitamins and aspirin, 7 were com plicated by preeclampsia. Birth weights were 2867 +/- 648 g compared w ith 1088 +/- 570 g in the previous pregnancies. CONCLUSIONS: Vitamin B -6 and folic acid correct the methionine loading test in patients with hyperhomocysteinemia. Perinatal outcome in patients with a history of preeclampsia or fetal growth restriction and hyperhomocysteinemia app ears to be favorable.