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Electronic Letters to:

Clinical Investigation:
W. Krajewski, M. Kucharska, B. Pilacik, M. Fobker, J. Stetkiewicz, J.-R. Nofer, and T. Wronska-Nofer
Impaired vitamin B12 metabolic status in healthcare workers occupationally exposed to nitrous oxide
Br. J. Anaesth. 2007; 0: aem280v1-7 [Abstract] [Full text] [PDF]
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Electronic letters published:

[Read E-letter] Nitrous oxide induceed Hyperhomocysteinemia and pregnancy loss
fatma Saricaoglu, Sennur Uzun   (20 November 2007)

Nitrous oxide induceed Hyperhomocysteinemia and pregnancy loss 20 November 2007
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fatma Saricaoglu,
MD
hacettepe University Dep of Anesthesiology and Reanimation,
Sennur Uzun

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Re: Nitrous oxide induceed Hyperhomocysteinemia and pregnancy loss

Editor- we read with interest the paper by Krajewski and colleagues outlining the impaired Vit B 12 metabolic status and significantly increased tHcy levels in female nurses with occupational exposure to N2O1. In our recent concluded study we examined the t Hcy levels with bad obstetrical outcome among the female operating room nurses. We hypothesised that occupational exposure to N2O causes hyperhomocystenemia and that is a risk factor for recurrent early pregnancy loss. There are several reports of hyperhomocystenemia associated with pregnancy disorders and recurrent pregnancy loss2, 3. Sixty female operating room nurses between 20-42 years with 2-25 years employment history in our university were included to our study. They answered a detailed questionnaire about their obstetrical history. All blood samples were collected on the same day for determination of tHcy, folic acid, Vit B12, anticardiolipin Ig M, Ig G, Antiphospholipid Ig M, Ig G. We did not use a control group because It will be second stage if we have got significant increases in t Hcy levels in our exposed group. Fortunately all measurements were in normal ranges among our university laboratory ranges and we have not any significant rate of abortions. Krajewski and colleagues reported lower Vit B12 and higher tHcy levels in exposed group. If it was possible to correlate the obstetrical outcome of these female nurses with hyperhomocysteinemia, this would be the first study to provea link between exposure to N2O, hyperhomocysteinemia and recurrent foetal loss. References: 1.Krajewski W, Kucharska M, Pilacik B, Fobker M, Stetkiewcz J, Nofer JR, Wronska-Nofer T. Impaired vitamin B12 metabolic status in healthcare workers occupationally exposed to nitrous oxide. Br J Anesth 2007; 20: 1- 7. 2. Hague WM. Homocysteine and pregnancy. Best Pract Res Clin Obstet Gynaecol. 2003 Jun; 17(3): 459-69. Review. 3. Nelen W, Blom HJ, Steegers EAP, Heijer M, Eskes T. Hyperhomocysteinemia and recurrent early pregnancy loss: a meta-analysis. Fertil Steril. 2000 Dec; 74(6): 1196-9.

Conflict of Interest:

None declared