Habitüel Abortusta Vitamin B12 ve Folatın Rolü

Öz

Amaç: Habitüel abortus etiyolojisinde birçok patofizyolojik mekanizma tanımlanmış olsa da vakaların yarısının nedeni hala aydınlatılamamıştır. Folat ve B12 vitamininin erken gebelik komplikasyonları üzerinde etkili olduğu bildirilmektedir. Biz de çalışmamızda habitüel abortus ile folat ve vitamin B12 düzeyleri arasındaki ilişkiyi ortaya koymayı amaçladık.

Materyal ve Metot: Habitüel abortus hikayesi olan 124 gebe ve böyle bir hikayesi olmayan 242 gebe olmak üzere, toplam 366 hasta çalışmaya dahil edilmiştir. Hastaların yaş, gestasyonel hafta, boy, kilo, vücut kitle indeksi (VKİ), gebelik, parite, düşük ve yaşayan çocuk sayısı ve vitamin B12 ve folat seviyeleri değerlendirildi.

Bulgular: Çalışma sonuçlarımıza göre çalışma grubunun yaş, gravida ve düşük sayıları kontrol grubundan anlamlı olarak yüksek bulunmuştur (p<0,05). Grupların boy, kilo ölçümleri, vitamin B12 ve folat ölçümleri arasında istatistiksel olarak anlamlı bir fark bulunmazken (p>0,05), çalışma grubunun VKİ ölçümleri ve yaşayan çocuk sayısı kontrol grubundan anlamlı olarak düşük bulunmuştur (p<0,05).

Sonuç: Çalışmamızın sonuçlarına göre vitamin B12 ve folat ile habitüel abrtus arasında herhangi bir anlamlı ilişki saptamadık. Konuyla ilgili literature katkıda bulunacak daha büyük örneklemli prospektif çalışmalara ihtiyaç vardır.

Anahtar Kelimeler: Folat

Anahtar Kelimeler

• Folat
• Habitüel abort
• Vitamin B12

The Role of Vitamin B12 and Folate in Habitual Abortion

Abstract

Objective: Although several pathophysiological mechanisms are defined in the etiology of habitual abortion, still causes half of the cases haven’t been clarified yet. It has been reported that folate and vitamin B12 are effective in early pregnancy complications. In our study, we aimed to reveal the relationship between habitual abortion with folate and vitamin B12 levels.

Materials and Methods: We included our study 124 pregnant having habitual abortion history and 242 pregnants without this, a total of 366 patients. Maternal and gestational age, height, weight, body mass index (BMI), gravidity, parity, abortion, and living children count and vitamin B12 and folate levels of these pregnants were evaluated retrospectively.

Results: The ages, gravidity, and abortion counts of the study group were significantly higher than the control group (p<0.05). While the weight, height measurements, vitamin B12, and folate measurements showed no significant difference (p>0.05) between groups, the BMI measurements, living children count, and of the study group were significantly lower than the control group (p<0.05). 

Conclusion: According to our results, we didn’t find any relationship between habitual abortion with folate and vitamin B12 levels. Further larger sample-sized and prospective studies are required to contribute to the literature about this issue. 

Keywords

• Folate
• habitual abortion
• vitamin B12

Kaynakça

1. Von Eye Corleta H. It is time to respect the American Society for Reproductive Medicine definition of recurrent pregnancy loss. Fertil Steril. 2010;94(4):e61. doi:10.1016/j.fertnstert. 2010.06.020
2. Regan L, Backos M, Rai R. Royal College of Obstetricians & Gynaecologists. The investigation and treatment of couples with recurrent first-trimester and second trimester miscarriage. Guideline No. 17, 2011. https://www.rcog.org.uk/globalassets/documents/guidelines/gtg_17.pdf. Accessed November 8, 2020.
3. Fritz M, Goldberg J, McClure RD et al. The Practice Committee of the American Society for Reproductive Medicine. Evaluation and treatment of recurrent pregnancy loss: a committee opinion. 2012. https://www.fertstert.org/action/showPdf?pii=S0015-0282%2812%2900701-7. Accessed November 8,2020.
4. Silver RM, Branch DW, Goldenberg R, Iams JD, Klebanoff MA. Nomenclature for pregnancy outcomes Time for a change. American Collage of Obsterics and Gynecology. 2011;118(6):1402-1408. doi:10.1097/AOG.0b013e3182392977
5. Pei C, Kim YJ, Baek K. Pathogenetic factors involved in recurrent pregnancy loss from multiple aspects. Obstet Gynecol. 2019;62(4):212-223. doi:10.5468/ogs.2019.62.4.212
6. Solé-Navais P, Cavallé-Busquets P, Fernandez-Ballart JD, Murphy MM. Early pregnancy B vitamin status, one carbon metabolism, pregnancy outcome and child development. Biochimie. 2016;126:91-96. doi:10.1016/j.biochi.2015.12.003
7. Yang T, Gu Y, Wei X et al. Periconceptional folic acid supplementation and vitamin B 12 status in a cohort of Chinese early pregnancy women with the risk of adverse pregnancy outcomes. J Clin Biochem Nutr. 2017;60(2):136-142. doi:10.3164/jcbn.16-45
8. Sukumar N, Rafnsson SB, Kandala N, Bhopal R, Yajnik CS, Saravanan P. Prevalence of vitamin B-12 insufficiency during pregnancy and its effect on offspring birth weight : a systematic review and meta analysis. Am J Clin Nutr. 2016;103:1232-1251. doi:10.3945/ajcn.115.123083

9. Dror DK, Allen LH. Interventions with Vitamins B6, B12 and C in pregnancy. Pediatr Perinat Epidemiol. 2012;26(1):55-74. doi:10.1111/j.1365-3016.2012.01277.x
10. George L, Mills JL, Johansson ALV, et al. Plasma folate levels and risk of spontaneous abortion. J Am Med Assoc. 2002;288(15):1867-1873. doi:10.1001/jama.288.15.1867.
11. Mujawar SA, Patil VW, Daver RG. Study of serum homocysteine, folic acid and vitamin B12 in patients with preeclampsia. Indian J Clin Biochem. 2011;26(3):257-260. doi:10.1007/s12291-011-0109-3
12. Puri M, Kaur L, Walia GK, Mukhopadhhyay R, Pal M. MTHFR C677T polymorphism, folate, vitamin B 12 and homocysteine in recurrent pregnancy losses : a case control study among north Indian women. J Perinat Med. 2013;41(5):8-13. doi:10.1515/jpm-2012-0252.
13. Al-badri HJA, Abdul-hassan M. Serum total homocysteine level in Iraqi woman with unexplained recurrent miscarriage. J Pak Med A. 2019;69(8):29.
14. Li Y, Gao R, Liu X et al. Folate deficiency could restrain decidual angiogenesis in pregnant mice. Nutrients. 2015;7(8):6425-6445. doi:10.3390/nu7085284
15. Selhub J. Homocysteine metabolism. Annu Rev Nutr. 1999;19:217-246. doi:10.1146/annurev. nutr.19.1.217
16. Sande H Van, Jacquemyn Y, Karepouan N, Ajaji M. Vitamin B12 in pregnancy: Maternal and fetal/neonatal effects-A review. Open J Obstet Gynecol. 2013;03(07):599-602. doi:10.4236/ojog.2013. 37107
17. Allen LH, Jones KM. Vitamin B12. In: Coates PM, ed. Encyclopedia of dietary supplements. 2nd ed. Boca Raton: CRC Press; 2015:431-452.
18. Scholl TO, Johnson WG. Folic acid: influence on the outcome of pregnancy. Am J Clin Nutr. 2000;71:1295-1303. doi:10.1093/ajcn/71.5.1295s
19. Hübner U, Alwan A, Jouma M, Tabbaa M, Schorr H, Herrmann W. Low serum vitamin B12 is associated with recurrent pregnancy loss in Syrian women. Clin Chem Lab Med. 2008;46(9):12651269. doi:10.1515/CCLM.2008.247
20. Krishnaveni GV, Hill JC, Veena SR et al. Low plasma vitamin B12 and high folate concentrations in pregnancy are associated with gestational diabesity and incident diabetes. Diabetologia. 2009;52(11):2350-2358. doi:10.1007/s00125-009-1499-0
21. Su M, Bussen S, Ruppert D, Steck T. Serum levels of folate and cobalamin in women with recurrent spontaneous abortion. Human Reproduction. 1997;12(10):2292-2296. doi:10.1093/humrep/12.10.2292
22. Ellatef DMA, Beteha GA, Hasan MM, Eid MA. The Relation between serum homocystiene level and recurrent abortion in Egyptian women. The Egyptian Journal of Hospital Medicine. 2018:70(5):731-738. doi:10.12816/0043975