Maternal red blood cell folate and vitamin B metabolism with pregnancy outcomes: a retrospective study

Abstract Background Vitamin B plays a crucial role in pregnancy, influencing maternal and fetal health. However, the impact of Vitamin B metabolism alterations on pregnancy outcomes remains unclear. This study investigates the association between Vitamin B metabolism and adverse pregnancy outcomes (...

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Main Authors: Limin Peng, Yan Gao, Chengkun Yuan, Hongying Kuang
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Pregnancy and Childbirth
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Online Access:https://doi.org/10.1186/s12884-025-07806-7
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author Limin Peng
Yan Gao
Chengkun Yuan
Hongying Kuang
author_facet Limin Peng
Yan Gao
Chengkun Yuan
Hongying Kuang
author_sort Limin Peng
collection DOAJ
description Abstract Background Vitamin B plays a crucial role in pregnancy, influencing maternal and fetal health. However, the impact of Vitamin B metabolism alterations on pregnancy outcomes remains unclear. This study investigates the association between Vitamin B metabolism and adverse pregnancy outcomes (APO) using a retrospective approach. Methods A total of 1,086 pregnant women were included, categorized into normal and APO groups. Vitamin B markers during pregnancy, including red blood cell (RBC) and plasma levels of folate (5MTHF), Vitamin B2 (VB2), and Vitamin B6 (VB6), as well as methylmalonic acid (MMA) and homocysteine (HCY), were analyzed. LASSO regression was used for feature selection, followed by logistic regression to develop a predictive model. The model’s performance was evaluated using ROC curve, calibration curves, decision curve analysis, and external validation. Results Higher plasma-5MTHF, RBC-5MTHF, RBC-VB2, and RBC-VB6 levels were significantly associated with normal pregnancy outcomes, whereas elevated MMA and HCY levels correlated with an increased risk of APO (P < 0.05). In addition, maternal age, pregnancy type, pre-BMI, and passive smoking were identified as significant baseline factors. By integrating these baseline characteristics with Vitamin B-related biomarkers, the predictive model demonstrated excellent performance, with an AUC of 0.85 (95% CI: 0.818–0.883) in the training set and 0.807 (95% CI: 0.738–0.876) in the external validation set. Conclusion Alterations in Vitamin B metabolism are significantly associated with pregnancy outcomes. The developed predictive model provides a valuable tool for risk assessment in clinical practice.
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spelling doaj-art-22a0f4aa61c842068c90dfd4b26168b22025-08-20T03:45:39ZengBMCBMC Pregnancy and Childbirth1471-23932025-07-0125111210.1186/s12884-025-07806-7Maternal red blood cell folate and vitamin B metabolism with pregnancy outcomes: a retrospective studyLimin Peng0Yan Gao1Chengkun Yuan2Hongying Kuang3Department of Obstetrics, The First Affiliated Hospital , Heilongjiang University of Chinese MedicineDepartment of Obstetrics, The First Affiliated Hospital , Heilongjiang University of Chinese MedicineDepartment of Obstetrics, The First Affiliated Hospital , Heilongjiang University of Chinese MedicineHeilongjiang University of Chinese MedicineAbstract Background Vitamin B plays a crucial role in pregnancy, influencing maternal and fetal health. However, the impact of Vitamin B metabolism alterations on pregnancy outcomes remains unclear. This study investigates the association between Vitamin B metabolism and adverse pregnancy outcomes (APO) using a retrospective approach. Methods A total of 1,086 pregnant women were included, categorized into normal and APO groups. Vitamin B markers during pregnancy, including red blood cell (RBC) and plasma levels of folate (5MTHF), Vitamin B2 (VB2), and Vitamin B6 (VB6), as well as methylmalonic acid (MMA) and homocysteine (HCY), were analyzed. LASSO regression was used for feature selection, followed by logistic regression to develop a predictive model. The model’s performance was evaluated using ROC curve, calibration curves, decision curve analysis, and external validation. Results Higher plasma-5MTHF, RBC-5MTHF, RBC-VB2, and RBC-VB6 levels were significantly associated with normal pregnancy outcomes, whereas elevated MMA and HCY levels correlated with an increased risk of APO (P < 0.05). In addition, maternal age, pregnancy type, pre-BMI, and passive smoking were identified as significant baseline factors. By integrating these baseline characteristics with Vitamin B-related biomarkers, the predictive model demonstrated excellent performance, with an AUC of 0.85 (95% CI: 0.818–0.883) in the training set and 0.807 (95% CI: 0.738–0.876) in the external validation set. Conclusion Alterations in Vitamin B metabolism are significantly associated with pregnancy outcomes. The developed predictive model provides a valuable tool for risk assessment in clinical practice.https://doi.org/10.1186/s12884-025-07806-7Vitamin B metabolismPregnancy outcomesPredictive model5MTHFExternal validation
spellingShingle Limin Peng
Yan Gao
Chengkun Yuan
Hongying Kuang
Maternal red blood cell folate and vitamin B metabolism with pregnancy outcomes: a retrospective study
BMC Pregnancy and Childbirth
Vitamin B metabolism
Pregnancy outcomes
Predictive model
5MTHF
External validation
title Maternal red blood cell folate and vitamin B metabolism with pregnancy outcomes: a retrospective study
title_full Maternal red blood cell folate and vitamin B metabolism with pregnancy outcomes: a retrospective study
title_fullStr Maternal red blood cell folate and vitamin B metabolism with pregnancy outcomes: a retrospective study
title_full_unstemmed Maternal red blood cell folate and vitamin B metabolism with pregnancy outcomes: a retrospective study
title_short Maternal red blood cell folate and vitamin B metabolism with pregnancy outcomes: a retrospective study
title_sort maternal red blood cell folate and vitamin b metabolism with pregnancy outcomes a retrospective study
topic Vitamin B metabolism
Pregnancy outcomes
Predictive model
5MTHF
External validation
url https://doi.org/10.1186/s12884-025-07806-7
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AT yangao maternalredbloodcellfolateandvitaminbmetabolismwithpregnancyoutcomesaretrospectivestudy
AT chengkunyuan maternalredbloodcellfolateandvitaminbmetabolismwithpregnancyoutcomesaretrospectivestudy
AT hongyingkuang maternalredbloodcellfolateandvitaminbmetabolismwithpregnancyoutcomesaretrospectivestudy