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Licensed Unlicensed Requires Authentication Published by De Gruyter July 17, 2008

Low serum vitamin B12 is associated with recurrent pregnancy loss in Syrian women

  • Ulrich Hübner , Ahmad Alwan , Muhidin Jouma , Mohammad Tabbaa , Heike Schorr and Wolfgang Herrmann


Background: Hyperhomocysteinemia and B-vitamin deficiency are associated with recurrent abortion. Recent studies have not investigated functional markers of vitamin B12 deficiency, such as methylmalonic acid.

Methods: A total of 43 consecutive Syrian women with unexplained recurrent abortion and 32 pregnant controls were enrolled in the study. Serum folate, vitamin B12, methylmalonic acid and plasma homocysteine were determined.

Results: Vitamin B12 was significantly decreased in patients with recurrent abortion compared to controls (mean concentrations 197 vs. 300 pg/mL, p=0.004). The lowest mean serum vitamin B12 (172 pg/mL) was observed in primary aborters. Homocysteine was elevated in aborters in comparison to controls (8.3 vs. 7.1 μmol/L, p=0.093). Folate and methylmalonic acid did not differ significantly between the study groups. A highly significant correlation between homocysteine and methylmalonic acid and vitamin B12 was observed only in patients but not in controls (p<0.001 and p=0.002, respectively). In the logistic regression model, only serum vitamin B12 emerged with a significant odds ratio.

Conclusions: The results confirm low serum vitamin B12 in recurrent abortion patients. However, methylmalonic acid did not support that functional vitamin B12 plays a role in this group. This unexpected result might be due to a decrease of the metabolically inert vitamin B12 fraction (holohaptocorrin) or confounding factors. Further studies are necessary to investigate the role of vitamin B12 deficiency in recurrent abortion.

Clin Chem Lab Med 2008;46:1265–9.

Corresponding author: Prof. Dr. Wolfgang Herrmann, Department of Clinical Chemistry and Laboratory Medicine, Central laboratory, University Hospital of the Saarland, Bldg. 57, 66421 Homburg, Germany Phone: +49-6841-1630700, Fax: +49-6841-1630703,

Received: 2008-1-3
Accepted: 2008-2-22
Published Online: 2008-07-17
Published in Print: 2008-09-01

©2008 by Walter de Gruyter Berlin New York

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