High frequency of maternal vitamin B12 deficiency as an important cause of infantile vitamin B12 deficiency in Sanliurfa province of Turkey

Köç, Ahmet; Koçyiğit, Abdürrahim; Soran, Mustafa; Demir, Nihat; Sevinç, Eylem; Erel, Özcan; Mil, Zeki

doi:10.1007/s00394-006-0598-7

Cited by 86 publications

(81 citation statements)

References 18 publications

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“…The facts that vitamin B 12 deficiency emerged most commonly between the ages of 6 and 18 months, that maternal serum vitamin B 12 levels were reduced in most cases, and that maternal nutrition was poor in vitamin B 12 -containing foods suggest that infantile deficiency of vitamin B 12 was secondary to maternal deficiency. Therefore, our results support those of previous studies (11,(20)(21)(22)(23)(24).…”

Section: Discussionsupporting

confidence: 93%

“…Weight, height, and head circumferences were measured in each infant, and physical development by age was determined using the percentile curves developed by Neyzi et al (10). This study was performed in a region where the population is large, birth rate is high, and nutritional vitamin B 12 deficiency is common due to sociocultural and nutritional habits (11). All patients in the study group were normal by percentile curves for age.…”

mentioning

confidence: 99%

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Visual and brainstem auditory evoked potentials in infants withsevere vitamin B12 deficiency

DEMİR¹,

Azhari²,

Abuhandan³

et al. 2015

Turk J Med Sci

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IntroductionVitamin B 12 is commonly found in foods of animal origin and is not synthesized in the human body. Vitamin B 12 , along with folic acid, participates in DNA synthesis and plays a role in nerve myelination, cell division, and proliferation. In babies exclusively fed with breast milk, the most common cause of vitamin B 12 deficiency is insufficient intake from vegetarian or vegan mothers who do not consume foods of animal origin (1). The severity of clinical symptoms is directly related to the severity of vitamin B 12 deficiency in the mother (2). The most common findings of vitamin B 12 deficiency are hematological and neurological signs. Several studies have reported that these neurological signs might be caused by demyelination, dysmyelination, and axonopathy (3). Abnormalities of visual evoked potentials (VEPs) and brainstem auditory evoked potentials (BAEPs) develop secondarily to demyelination and axonopathy caused by vitamin B 12 deficiency. The persistence of VEP and BAEP abnormality in the deficiency of vitamin B 12 might be associated with delayed diagnosis of vitamin B 12 deficiency and advanced neurological picture (3-6). The other findings are as follows: growth-developmental retardation, gastrointestinal motility disorders (diarrhea), hyperpigmentation, stomatitis, glossitis, irritability, weakness, lethargy, hypotonia, ataxia, hyporeflexia, tremor, convulsion, movement disorders, abnormal mental states, retardation in acquired motor skills, and coma (2,4,7-9).We could not find any controlled study in the literature about the effects of vitamin B 12 deficiency on the evoked brain potentials in infants. Thus, in this study we aimed to determine the effects of vitamin B 12 deficiency on VEP and BAEP in infants, and to investigate the results of treatment. Materials and methods Patient selectionA total of 30 infants aged 6-24 months with retardation of mental, motor, cognitive, and social functions and diagnosed with moderate or severe vitamin B 12 deficiency Background/aim: Vitamin B 12 plays an important role in the development of mental, motor, cognitive, and social functions via its role in DNA synthesis and nerve myelination. Its deficiency in infants might cause neuromotor retardation as well as megaloblastic anemia. The objective of this study was to investigate the effects of infantile vitamin B 12 deficiency on evoked brain potentials and determine whether improvement could be obtained with vitamin B 12 replacement at appropriate dosages.Materials and methods: Thirty patients with vitamin B 12 deficiency and 30 age-matched healthy controls were included in the study. Hematological parameters, visual evoked potentials, and brainstem auditory evoked potentials tests were performed prior to treatment, 1 week after treatment, and 3 months after treatment.Results: Visual evoked potentials (VEPs) and brainstem auditory evoked potentials (BAEPs) were found to be prolonged in 16 (53.3%) and 15 (50%) patients, respectively. Statistically significant improvements in VEP and BAEP examinations w...

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Section: Discussionsupporting

confidence: 93%

mentioning

confidence: 99%

Visual and brainstem auditory evoked potentials in infants withsevere vitamin B12 deficiency

DEMİR¹,

Azhari²,

Abuhandan³

et al. 2015

Turk J Med Sci

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“…It is difficult to quantify the prevalence of deficiency in pregnant women partly due to the gradual decline in the plasma B12 concentration throughout gestation. Based on gestational week prevalence of deficiency worldwide may vary from 5% (<28 days gestation) to 72% (immediately prior to delivery) [35,36]. In south Asia, examples of reported prevalence of deficiency include 27% of pregnant woman at early to late pregnancy (i.e.…”

Section: Vitamin B12 Deficiencymentioning

confidence: 99%

Vitamin B12 Deficiency in Pregnancy and Lactation: Is there a Need for Pre and Post-natal Supplementation?

Siddiqua¹,

Allen²,

Raqib³

et al. 2014

J Nutr Disorders Ther

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This article reviews vitamin B12 (B12) status and deficiency during pregnancy and lactation, its effect on pregnancy, and the health of the offspring, with the aim to underscore the need for a sustainable strategy to improve maternal and infant vitamin B12 status of low and middle income countries. Vitamin B12 is a basic nutrient required for maintenance of normal erythropoiesis, cell reproduction, nucleoprotein and myelin synthesis. B12 deficiency is associated with adverse pregnancy outcomes and neurodevelopmental morbidity during infancy. Very few studies have indicated that B12 deficiency may contribute to altered immune responses in animals and humans. Additionally, no studies have shown modulation of infant motor development in response to maternal B12 supplementation. Despite the high global prevalence of B12 deficiency and its serious effects on pregnant women and offspring, there is still no consensus on the cut-off of biochemical markers (indicator of B12 deficiency) to correctly diagnose B12 deficiency in mother-infant dyad. Also, the optimum dose of B12 to normalize B12 status of mother-infant pairs in a deficient population is not known yet. In addition, markers of other functions such as neurodevelopment, immune response that may be affected by vitamin B12 deficiency should be measured to determine if they respond to supplementation. Thus, there is an urgent need to conduct more trials to find out the optimum dose, to investigate whether intervention with such pre-and post natal vitamin B12 supplementation would improve maternal, neonatal and child health outcomes in population at risk, giving emphasis on neurological processes, immune functions and epigenetic modifications. Other strategies including food based approach also require evidence based results which will help to understand effectiveness of a targeted and well-designed intervention among this population.

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“…'lar› (17) sadece anne sütü alan bebeklerin özellikle ilk iki aya kadar olan dönemde B12 ile homosistein düzeyleri aras›nda bir iliflki oldu¤unu ve 200 pg/ml'nin üzerin-deki B12 de¤erlerinde homosistein düzeylerinin 7,5 mmol/L'nin alt›nda ve metilmalonik asit düzeylerinin normal de¤er aral›¤› içerisinde kald›¤›n› göstermifllerdir. Bu nedenle biz de çal›flmam›zda homosistein düzeyine göre yenido¤an (19) Urfa'da yapm›fl olduklar› bir çal›flmada ise B12 eflik de¤eri için laboratuvar eflik de¤eri (160 pg/mL) al›nmas›na ra¤men annelerin %72'sinde, bebeklerin %41'inde B12 eksikli¤i saptam›fllar-d›r. Söz konusu çal›flmalar›n ve bizim çal›flmam›z›n bir di¤er ortak noktas› annelerdeki yetersizli¤in bebeklerden daha fazla oranda saptanmas›d›r.…”

Section: Tart›flmaunclassified

“…'lar› (17) sadece anne sütü ile beslenen olgular›n yenido¤an dönemindeki B12 düzeylerinin ilk alt› ayl›k dö-nemde de¤iflmedi¤ini, formula ile beslenmeleri durumunda B12 düzeyinin anlaml› olarak artt›¤›n› göstermifllerdir. Bu durumda annesinde B12 yetersizli¤i olup, kendisinde eksiklik saptanmayan bebekler do¤um sonras› dönemde sadece anne sütü almalar› durumunda risk alt›ndad›r (19)(20)(21). Bu nedenle annenin B12 düzeyinin bebe¤in B12 düzeyinden daha yüksek olmas› gerekti¤ini düflünmekteyiz.…”

Section: Tart›flmaunclassified

Gelişmekte olan ülkelerde önemli bir sorun: annede ve yenidoğanda B12 vitamini eksikliği

Önal¹,

Adal²,

Öner³

et al. 2010

tpa

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G Ge el li ifl flm me ek kt te e o ol la an n ü ül lk ke el le er rd de e ö ön ne em ml li i b bi ir r s so or ru un n: : a an nn ne ed de e v ve e y ye en ni id do o¤ ¤a an nd da a B B1 12 2 v vi it ta am mi in ni i e ek ks si ik kl li i¤ ¤i i A An n i im mp po or rt ta an nt t p pr ro ob bl le em m i in n d de ev ve el lo op pi in ng g c co ou un nt tr ri ie es s: : m ma at te er rn na al l a an nd d n ne eo on na at ta al l v vi it ta am mi in n B B1 12 2 d de ef fi ic ci ie en nc cy y H Ha as sa an n Ö Ön na al l, , E Er rd da al l A Ad da al l, , T Ta al li ih ha a Ö Ön ne er r, , Z Ze er rr ri in n Ö Ön na al l, , A Ah hm me et t A Ay yd d› ›n n* * Ö Öz zg gü ün n A Ar ra afl flt t› ›r rm ma a O Or ri ig gi in na al l A Ar rt ti ic cl le e Ö Öz ze et t Amaç: Son y›llarda yaflam›n ilk alt› ayl›k dönemi içinde nörolojik bulgular ile hastanemize baflvuran ve B12 eksikli¤i tan›s› alan olgularda ciddi bir art›fl dikkat çekmifltir. Bundan dolay› hastanemizde do¤an bebeklerde annede ve bebekte B12 eksikli¤inin araflt›r›lmas› gere¤i duyulmufltur. Gereç ve Yöntem: Çal›flma grubu hastanemizde do¤um yapan 250 anne ve do¤um sonras› 48 saatini doldurmufl term bebeklerden oluflturuldu. Annede B12, bebekte B12 ve homosistein düzeyi ölçüldü. Hiperhomosisteinemisi bulunan olgularda B12 yetersizli¤i ile kobalamin sentez bozuklu¤u ay›r›c› tan›s› yap›ld›. B12 eksikli¤i tan›s›n›n konulmas›nda annede B12 eflik de¤eri 300 pg/ml, bebekte 200 pg/ml olarak al›nd›. Bulgular: Annelerin %81,6's›nda bebeklerin %42'sinde B12 yetersizli¤i saptand›. B12 eksikli¤i bulunan olgular›n ortalama homosistein düze-yi B12 düzeyi normal olan olgulara göre anlaml› olarak yüksek bulundu. Kobalamin sentez bozuklu¤u hiçbir olguda saptanmad›. Ç›kar›mlar: Sosyoekonomik seviyenin düflük olmas› nedeni ile hayvansal proteinlerin anneler taraf›ndan yeterince tüketilememesi, hem anne hem de bebek için B12 vitamin eksikli¤i aç›s›ndan önemli bir neden olarak gözükmektedir. Bu çal›flma bizim gibi geliflmekte olan ülkelerde gebelik döneminde B12 deste¤inin kas içine uygulanarak karfl›lanmas› gereklili¤ini tart›flmaya açmaktad›r. ( S Su um mm ma ar ry yAim: A significant increase has been noted in the number of infants admitted to our hospital due to neurologic findings and diagnosed as vitamin B12 deficiency within the first 6 months of life. Therefore, the aim of the present study was to determine the presence of maternal and neonatal vitamin B12 deficiency in infants born in our hospital. Material and Method:The study population consisted of 250 women giving birth in our hospital and term newborns completing 48 hours after birth. Serum vitamin B12 levels were measured in mothers and vitamin B12 and homocysteine levels were measured in their newborns. The differential diagnosis between vitamin B12 deficiency and impaired cobalamin synthesis was made in infants with hyperhomocysteinemia. The diagnostic threshold for vitamin B12 deficiency was 300 pg/mL in mothers and 200 pg/mL in newborns. Results: Vitamin B12 deficiency was found in 81.6% of the mothers and 42%...

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High frequency of maternal vitamin B12 deficiency as an important cause of infantile vitamin B12 deficiency in Sanliurfa province of Turkey

Cited by 86 publications

References 18 publications

Visual and brainstem auditory evoked potentials in infants withsevere vitamin B12 deficiency

Visual and brainstem auditory evoked potentials in infants withsevere vitamin B12 deficiency

Vitamin B12 Deficiency in Pregnancy and Lactation: Is there a Need for Pre and Post-natal Supplementation?

Gelişmekte olan ülkelerde önemli bir sorun: annede ve yenidoğanda B12 vitamini eksikliği

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