Evidence map›Paper›PMID 32188521›Full record

ArticlePublic health nutrition2020

The determinants of maternal homocysteine in pregnancy: findings from the Ottawa and Kingston Birth Cohort.

Shazia H Chaudhry, Monica Taljaard, Amanda J MacFarlane, Laura M Gaudet, Graeme N Smith, Marc Rodger, Ruth Rennicks White, Mark C Walker, Shi Wu Wen

Registry-linked trialOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Public health nutrition, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06413576 (The Clinical Utility of Homocysteine in Critically Ill Preeclampsia Patients), which is not on this map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.1field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06413576 completednot on this mapstarted 2024, after this paper: background citation

The Clinical Utility of Homocysteine in Critically Ill Preeclampsia Patients

TypeobservationalSponsorAin Shams UniversityRan2024 to 2025Enrolled70ConditionsPre-Eclampsia, Critical IllnessArmshomocysteine measurement
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
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  4. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 1 country.

Shazia H ChaudhryThe Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Monica TaljaardThe Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Amanda J MacFarlaneNutrition Research Division, Health Canada, Ottawa, Ontario, Canada.
Laura M GaudetThe Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Graeme N SmithDivision of Maternal-Fetal Medicine, Department of Obstetrics & Gynaecology, Queen's University, Kingston, Ontario, Canada.
Marc RodgerThe Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Ruth Rennicks WhiteThe Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Mark C WalkerThe Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Shi Wu WenThe Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Ottawa Hospital Research InstituteOttawa Hospital · CAUniversity of Ottawa · CAHealth Canada · CAKingston General Hospital · CA

Funding

CIHR 82802CIHR FDN 148438CIHR MOP 53188
6 · The paper itself

Abstract

objectiveObservational studies have linked elevated homocysteine to vascular conditions. Folate intake has been associated with lower homocysteine concentration, although randomised controlled trials of folic acid supplementation to decrease the incidence of vascular conditions have been inconclusive. We investigated determinants of maternal homocysteine during pregnancy, particularly in a folic acid-fortified population.

designData were from the Ottawa and Kingston Birth Cohort of 8085 participants. We used multivariable regression analyses to identify factors associated with maternal homocysteine, adjusted for gestational age at bloodwork. Continuous factors were modelled using restricted cubic splines. A subgroup analysis examined the modifying effect of MTHFR 677C>T genotype on folate, in determining homocysteine concentration.

settingParticipants were recruited in Ottawa and Kingston, Canada, from 2002 to 2009.

participantsWomen were recruited when presenting for prenatal care in the early second trimester.

resultsIn 7587 participants, factors significantly associated with higher homocysteine concentration were nulliparous, smoking and chronic hypertension, while factors significantly associated with lower homocysteine concentration were non-Caucasian race, history of a placenta-mediated complication and folic acid supplementation. Maternal age and BMI demonstrated U-shaped associations. Folic acid supplementation of >1 mg/d during pregnancy did not substantially increase folate concentration. In the subgroup analysis, MTHFR 677C>T modified the effect of folate status on homocysteine concentration.

conclusionsWe identified determinants of maternal homocysteine relevant to the lowering of homocysteine in the post-folic acid fortification era, characterised by folate-replete populations. A focus on periconceptional folic acid supplementation and improving health status may form an effective approach to lower homocysteine.

Indexed as

HomocysteineHomocystinuriaCanadaFemaleFolic AcidHumansMethylenetetrahydrofolate Reductase (NADPH2)PregnancyFolic AcidHomocysteineMethylenetetrahydrofolate Reductase (NADPH2)Birth cohortHomocysteineHyperhomocysteinaemiaMTHFR (methylenetetrahydrofolate reductase)Pregnancy

Identifiers

PMID32188521
PMCPMC10200619
OpenAlexW3011154463

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.