Association of Maternal Vitamin B12 Status With Infant Findings and Neurodevelopment in Vitamin B12-Deficient Breast-fed Babies

Abstract

Few studies have examined the association between maternal vitamin B 12 status and their breast-fed infants' findings. The objective of this study was to analyze the association of maternal B 12 status with infant findings including neurodevelopmental outcome in breast-fed babies with B 12 deficiency. Correlation analyses between the laboratory findings of infants with B 12 deficiency (n = 120) and their mothers were performed and the association of maternal B 12 status with infant findings including the Denver-II developmental screening test (DDST II) results was examined. There was a significant correlation between infant and maternal B 12 levels (r = 0.222; P = 0.030), and between infant and maternal homocysteine (Hcy) levels (r = 0.390; P < 0.001). Among the babies 4 months of age or older, maternal Hcy levels were significantly correlated with infant mean corpuscular hemoglobin (r = 0.404; P = 0.001) and infant mean corpuscular volume (r = 0.461; P < 0.001). Mothers of infants with abnormal DDST II had lower vitamin B 12 (196.9 ± 41.2 vs. 247.0 ± 77.0 pg/mL; P = 0.018) and higher Hcy levels (17.3 ± 5.0 vs. 10.7 ± 3.1 µmol/L; P < 0.001) than mothers of infants with normal DDST II. A lower maternal vitamin B 12 status may be related to impaired neurodevelopment in breast-fed infants with vitamin B 12 deficiency. Pregnant and lactating women should be offered easy access to healthy nutrition and vitamin B 12 supplements.

Maternal Vitamin B12 Status during Pregnancy and Early Infant Neurodevelopment: The ECLIPSES Study

“…The findings of scarce studies with regard to maternal vitamin B12 status during pregnancy and its effects on child neurodevelopment [ 27 , 28 , 29 , 30 , 31 , 32 , 33 ] have been heterogeneous. The methodological characteristics of the studies, including the different design and B12-deficiency cutoff values, as well as the socio-demographic factors of each population, may be behind this diversity in results.…”

“…The methodological characteristics of the studies, including the different design and B12-deficiency cutoff values, as well as the socio-demographic factors of each population, may be behind this diversity in results. Those conduced in developing Asian countries [ 27 , 28 , 29 ] reported a negative effect on neurodevelopment; however, neither of the two studies realized in developed countries, such as Canada [ 32 ] and the Netherlands [ 33 ], found any effect of low B12 levels.…”

“…As far as we know, only seven observational studies have focused on these topics, and their findings are not conclusive. Five studies were conducted in Asian countries [ 27 , 28 , 29 , 30 , 31 ], one was conducted in Canada [ 32 ], and one in the Netherlands [ 33 ]. Of the five Asian studies, the research conducted by Keskin et al [ 27 ] reported that low maternal vitamin B12 status in the first trimester was associated with impaired motor, language, and social skills in four-month-old infants who were also found to have vitamin B12 deficiency [ 27 ].…”

“…Five studies were conducted in Asian countries [ 27 , 28 , 29 , 30 , 31 ], one was conducted in Canada [ 32 ], and one in the Netherlands [ 33 ]. Of the five Asian studies, the research conducted by Keskin et al [ 27 ] reported that low maternal vitamin B12 status in the first trimester was associated with impaired motor, language, and social skills in four-month-old infants who were also found to have vitamin B12 deficiency [ 27 ]. Two other studies found that low maternal vitamin B12 levels during the third trimester were associated with lower cognition [ 28 , 29 ] and social development [ 29 ] in offspring at two years of age.…”

“…It should be borne in mind, however, that all previous observational studies on maternal vitamin B12 status and offspring neurodevelopmental outcomes have evaluated vitamin B12 concentrations only at one point in the pregnancy [ 27 , 28 , 29 , 30 , 31 , 32 , 33 ]. Nevertheless, previous findings in this research field suggest that this relationship depends on the pregnancy trimester in which the mother had this deficiency [ 22 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ]. The trimester in which the fetus is most susceptible to prenatal vitamin B12 status, and indeed how this may affect child neurodevelopment, therefore remains to be determined.…”