Hyperhomocysteinemia has also been suspected as a risk factor for pregnancy complications and birth defects. Elevated plasma homocysteine levels have been associated with placental vasculopathy, pre-eclampsia, and placental infarction, as well as recurrent premature delivery, low birth weight, and spontaneous abortion. Birth defects associated with hyperhomocysteinemia in the mother include neural tube defects, orofacial clefts, clubfoot, and Down's syndrome. The protective effect of folic acid supplementation and fortification against neural tube defects, and perhaps the other abnormal birth outcomes cited, may be related to reduced homocysteine levels.
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