Moderately elevated preconception fasting plasma total homocysteine is a risk factor for psychological problems in childhood

Objective We investigated the effect of maternal preconception fasting plasma total homocysteine (tHcy) on psychological problems in children aged 6 years from normal pregnancies. Design A longitudinal study was carried out from preconception, throughout each trimester of pregnancy, until 6 years of age in the offspring. Fasting blood samples at 2-10 weeks preconception and non-fasting samples at birth were collected. Parents completed the Child Behaviour Checklist (CBCL) and teachers the Inattention-Overactivity with Aggression (IOWA) scale for the 6-year-old children. Setting Elevated tHcy during pregnancy has been associated with several adverse outcomes and with neurodevelopmental impairment in the offspring. Participants The initial sample consisted of 139 healthy non-pregnant women who were planning on becoming pregnant. Eighty-one mother-child dyads were followed from preconception until 6 years of age. Results After adjusting for covariables, multiple linear regression models showed that higher preconception tHcy was associated with higher scores in internalizing dimension (beta=0.289; P=0.028), specifically in withdrawn behaviour (beta=0.349; P=0.009), anxiety/depression (beta=0.303; P=0.019) and social problems (beta=0.372; P=0.009). Aggressive behaviour in the school setting was higher in children whose mothers had higher preconception tHcy (beta=0.351; P=0.014). Conclusions Moderately elevated preconception tHcy may increase the risk of psychological problems in offspring during childhood. These findings add to the evidence that maternal nutritional status, even before being pregnant, can affect later offspring health and may be important to consider when developing future public health policy.