Intrauterine Growth Retardation, Perinatal Death, and Maternal Homocysteine Levels

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Abstract
Intrauterine growth retardation is associated with atheroma-like lesions in the arteries of the placental bed.1 The finding of increased resistance to uterine-artery blood flow is predictive of both preeclampsia and intrauterine growth retardation.2 Hyperhomocysteinemia has been identified as an important risk factor for occlusive vascular disease in nonpregnant adults,3 but its effect on the uteroplacental vasculature is not known. Women with homocystinuria due to cystathionine β-synthase deficiency may have an increased incidence of pregnancy loss,4 and a recent report by Steegers-Theunissen et al. (April 25 issue)5 suggests that mothers of babies with neural-tube defects have increased circulating homocysteine concentrations.