Periconceptional maternal biomarkers of one-carbon metabolism and embryonic growth trajectories: the Rotterdam Periconceptional Cohort (Predict Study).

OBJECTIVE

To study the associations between the periconceptional maternal biomarkers of one-carbon metabolism and embryonic growth.

DESIGN

Prospective, periconceptional hospital-based birth cohort.

SETTING

Tertiary medical care center.

PATIENT(S)

Between 2010 and 2014, 236 women with early singleton ongoing pregnancies that resulted in 139 strictly dated spontaneous pregnancies and 97 pregnancies conceived after assisted reproductive technology.

INTERVENTION(S)

None.

MAIN OUTCOME MEASURE(S)

Maternal serum vitamin B and plasma total homocysteine (tHcy) assessed at enrollment, and longitudinal first-trimester crown-rump length (CRL), embryonic volume (EV), and absolute growth rates obtained via three-dimensional ultrasound (3D-US) and virtual reality.

RESULT(S)

In early pregnancy, we performed a median of five 3D-US scans (range: 1-7). Vitamin B concentrations were positively associated with CRL and EV measurements in the total population (CRL: β 5ˆ10 (1ˆ10 to 9ˆ10) √mm; EV: β 2ˆ10 (0ˆ10 to 4ˆ10) √cm) and in the strictly dated spontaneous pregnancy subgroup. The tHcy concentration was negatively associated with embryonic growth in all study groups. High tHcy concentrations (+2 standard deviation [SD], 10.3 μmol/L) were associated with a 1.7 mm smaller CRL (-13.4%) at 7 weeks and a 3.6-mm smaller CRL (-7.1%) at 11 weeks compared with -2 SD tHcy (-3.0 μmol/L). A high tHcy concentration was also associated with a 0.10 cm smaller EV (-33.3%) at 7 weeks and a 1.65 cm smaller EV (-16.1%) at 11 weeks. The embryonic growth rate was positively associated with vitamin B and negatively associated with tHcy.

CONCLUSION(S)

Minor variations in periconceptional maternal concentrations of one-carbon metabolism biomarkers are associated with human embryonic growth.

Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.