Vitamin B12 status in pregnant women and their infants in South India

• DOI: 10.1038/ejcn.2017.29
• Publication Date: 2017-04-12T14:01:44Z
• Authors: J L Finkelstein; A V Kurpad; T Thomas; K Srinivasan; C Duggan
• Keywords: Male; 2. Zero hunger; 0303 health sciences; Infant, Newborn; India; Vitamin B 12 Deficiency; 3. Good health; Pregnancy Complications; Vitamin B 12; Young Adult; 03 medical and health sciences; Treatment Outcome; Pregnancy; Humans; Female; Pregnancy Trimesters; Prospective Studies; Biomarkers; Methylmalonic Acid

ObjectiveTo determine the prevalence of vitamin B12 deficiency in a prospective cohort study of pregnant women, and its associations with infant vitamin B12 status and adverse birth outcomes in Southern India.MethodsPregnant women (n=419) participating in a perinatal cohort study in India were enrolled before 12 weeks gestation and monitored to assess vitamin B12 and folate status during pregnancy. Plasma vitamin B12 concentrations, methylmalonic acid, and homocysteine concentrations and erythrocyte folate concentrations were measured in maternal samples at enrollment and in infant cord blood at delivery. Binomial and linear regression models were used to evaluate the associations between maternal and infant vitamin B12 status.ResultsThe median vitamin B12 concentrations in maternal and infant samples were 26.9 (IQR: 89.6, 172.2) and 173.7 (IQR: 108.6, 264.1) pmol/L. 64% of mothers were vitamin B12 deficient (<150 pmol/L) at their first trimester visit, and 41% of infants were vitamin B12 deficient at birth. Maternal vitamin B12 concentrations at baseline were associated with significantly higher infant vitamin B12 concentrations (p<0.0001) and lower risk of infant vitamin B12 deficiency (RR: 0.58, 95% CI: 0.49–0.69, p<0.0001). Maternal vitamin B12 deficiency was associated with significantly lower infant vitamin B12 concentrations (p<0.0001) and two‐fold higher risk of infant vitamin B12 deficiency (RR: 1.99, 95% CI: 1.44–2.75, p<0.0001) at birth. Maternal vitamin B12 deficiency was also associated with significantly higher risk of infant small‐for‐gestational age (RR: 1.48, 95% CI: 1.04–2.13, p=0.03).ConclusionsInadequate maternal vitamin B12 status during pregnancy predicted increased risk of infant vitamin B12 deficiency. Future interventions are needed to improve vitamin B12 status in women of reproductive age to reduce the risk of vitamin B12 deficiency in mothers and their infants.Support or Funding InformationDivision of Nutritional Sciences, Cornell University