Review of Vitamin B12 deficiency in pregnancy: a diagnosis not to miss as veganism and vegetarianism become more prevalent

Abstract

Vegetarianism and veganism are increasingly popular. The Food Standards Agency, biennial Food and You Survey of adults aged 16 years and over living in the UK, found that between 2012 and 2018 the proportion of people who reported never consuming dairy products had increased from 2% to 5%. However, veganism risks development of vitamin B12 deficiency as it is not available from plant sources. Moreover, its impact may be slow to be detected because body stores of vitamin B12 can last years. There is currently no published guidance on antenatal diagnosis and management of vitamin B12 deficiency. This paper reviews the metabolism, diagnosis and treatment of vitamin B12 in pregnancy. It concludes that national screening policymakers should consider introducing screening for B12 deficiency into the Antenatal and Newborn Screening Programmes for mothers and their infants if at risk of vitamin B12 deficiency. In the interim, national policy should be developed for prophylactic vitamin B12 supplementation in high‐risk groups around the time of pregnancy.

Cross-Sectional Study of the Prevalence of Cobalamin Deficiency and Vitamin B12 Supplementation Habits among Vegetarian and Vegan Children in the Czech Republic

“…It is known that, similar to vegans, vegetarians who do not consume enough vitamin B12 supplementation have a higher risk of deficiency than people eating a regular diet [10]. With the increase in popularity of plant-based diets worldwide, it is essential to consider the possible adverse effects of vitamin B12 deficiency [1,2]. Unfortunately, vitamin B12 supplements are not always well-received by the vegan community.…”

“…In one original research, more than 78% of Slovak vegans have got laboratory signs of cobalamin deficiency [11]. A balanced maternal diet during pregnancy and breastfeeding is critical for the mother's well-being and her offspring's growth and development [2]. Inadequate maternal vitamin B12 consumption during breastfeeding can result in low vitamin B12 levels in breast milk, which can cause lifelong developmental deficits in their children [2].…”

“…A balanced maternal diet during pregnancy and breastfeeding is critical for the mother's well-being and her offspring's growth and development [2]. Inadequate maternal vitamin B12 consumption during breastfeeding can result in low vitamin B12 levels in breast milk, which can cause lifelong developmental deficits in their children [2]. The incidence of cobalamin deficiency in breastfed babies is primarily determined by the mother's vitamin B12 status; therefore, vegetarian and vegan populations are particularly at risk [12][13][14].…”

“…The popularity of plant-based diets has increased over the past decades, mainly as a consequence of perceived health and environmental benefits and ethical reasons [1,2].…”

“…Although much information is available online, dietary guidelines on B12 intake in children on plant-based diets are scarce. On the other hand, the percentage of VN and VG mothers is increasing, as well as the risk of vitamin B12 deficiency in this particularly sensitive period of the child's development [2].…”