Severe Vitamin B12 Deficiency in an Infant Associated With a Maternal Deficiency and a Strict Vegetarian Diet

Weiss, Rachel; Fogelman, Yacov; Bennett, Michael

doi:10.1097/00043426-200404000-00013

Cited by 66 publications

(58 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[18][19][20] Several studies report severe neurological effects and classical demyelination lesions in infants of mothers on diets that are deficient in vitamin B 12 . [21][22][23] Although this study did not focus on deficient versus non-deficient groups, lower levels of vitamin B 12 could contribute to the changes in autonomic regulation such as an increased heart rate. Furthermore, low vitamin B 12 and folate concentrations are linked to high homocysteine concentrations.…”

Section: Discussionmentioning

confidence: 99%

Vitamin B₁₂ and folate status in early pregnancy and cardiometabolic risk factors in the offspring at age 5–6 years: findings from the ABCD multi‐ethnic birth cohort

Krikke

Grooten

Vrijkotte³

et al. 2015

BJOG

View full text Add to dashboard Cite

Objective To explore whether maternal vitamin B 12 and folate status during early pregnancy are associated with cardiometabolic risk factors in the offspring at age 5-6.Design Prospective multi-ethnic birth cohort, the Amsterdam Born Children and their Development study (ABCD). Population Mother-child pairs for whom information on maternal vitamin B 12 or folate status in early gestation and health at age 5-6 years was available (n = 1950).Methods Vitamin B 12 and folate concentrations were determined in maternal serum at intake in early pregnancy (median 13 weeks' gestation). Anthropometric measurements, blood pressure and fasting blood samples were collected during a health check of children aged 5-6 years. Multiple linear regression was performed to investigate the association between maternal serum concentrations and children's outcomes, corrected for confounders.Main outcome measures Gestational age at birth, birthweight, body mass index (BMI), glucose levels, triglyceride levels, blood pressure and heart rate of the offspring at age 5-6.Results Low maternal folate levels during early pregnancy were associated with slightly higher BMI in the offspring [decrease per 10 units: b 0.07 kg/m 2 , 95% confidence interval (CI) 0.01, 0.13].Low maternal vitamin B 12 concentrations were associated with higher heart rates (decrease per 100 units: b 0.49 beats/min, 95% CI 0.11, 0.87).Conclusion This study provides further evidence that maternal nutrition in early pregnancy may possibly program cardiometabolic health of the offspring.Keywords Body mass index, folate, heart rate, offspring, pregnancy, vitamin B 12 .Tweetable abstract Low folate and vitamin B 12 levels during pregnancy are associated with higher BMI and heart rate in offspring.Please cite this paper as: Krikke GG, Grooten IJ, Vrijkotte TGM, van Eijsden M, Roseboom TJ, Painter RC. Vitamin B 12 and folate status in early pregnancy and cardiometabolic risk factors in the offspring at age 5-6 years: findings from the ABCD multi-ethnic birth cohort. BJOG 2016;123:384-392.

show abstract

Section: Discussionmentioning

confidence: 99%

Vitamin B₁₂ and folate status in early pregnancy and cardiometabolic risk factors in the offspring at age 5–6 years: findings from the ABCD multi‐ethnic birth cohort

Krikke

Grooten

Vrijkotte³

et al. 2015

BJOG

View full text Add to dashboard Cite

show abstract

“…In this population, the iron intake from complementary feeds was inadequate, and this appeared to be exacerbated when 12-23-mo-old children continued to breastfeed. Vitamin B-12 deficiency is well recognized in exclusively breastfed infants of vitamin B-12-deficient mothers (46,47). Previous studies in urban Indian toddlers have also shown that vitamin B-12 concentrations are lower, the prevalence of vitamin B-12 deficiency is higher, folate concentrations are higher, and the prevalence of folate deficiency is lower in children who continue to receive breast milk (34).…”

Section: Tablementioning

confidence: 99%

Vitamin B-12, folate, iron, and vitamin A concentrations in rural Indian children are associated with continued breastfeeding, complementary diet, and maternal nutrition

Pasricha

Shet

Black

et al. 2011

The American Journal of Clinical Nutrition

View full text Add to dashboard Cite

Background: Determinants of vitamin B-12, folate, iron, and vitamin A concentrations in young children in rural south Asia are poorly understood. These micronutrients are crucial for the production of hemoglobin and have other important physiologic functions. Objective: We sought to develop explanatory models for concentrations of vitamin B-12, folate, ferritin, and retinol binding protein (RBP) in children aged between 1 and 2 y in rural Karnataka, India. Design: We performed a cross-sectional study in 12-23-mo-old toddlers who lived in 2 rural districts of Karnataka, India. For each child, data concerning dietary, food-security, and sociodemographic and maternal factors were obtained, and serum vitamin B-12, folate, ferritin, and RBP were measured. Multiple regression and structural equation modeling were applied to determine associations with micronutrient concentrations. Results: Of 396 sampled children, 254 children (65.6%) had at least one micronutrient deficiency. With the use of multiple regression, continued breastfeeding was independently associated with the concentration of each micronutrient [(log) vitamin B-12: standardized coefficient of 20.30 (P , 0.001); folate: standardized coefficient of +0.20 (P , 0.001); (log) ferritin: standardized coefficient of 20.18 (P = 0.004); (log) RBP: standardized coefficient of20.21 (P , 0.001)]. Children who continued to breastfeed received less nutrition from complementary foods and belonged to poorer families with higher food insecurity. A structural equation model for children's vitamin B-12 concentrations was developed that highlighted the interrelation between wealth, continued breastfeeding, complementary diet, and vitamin B-12 concentrations in children.

show abstract

“…B12 insufficiency during lactation may cause anaemia and neurological damage in both the mother and the breast-fed child, as has been reported in vegetarians (Metz, 1970;Michaud et al, 1992;Weiss et al, 2004). If maternal folate stores are insufficient prior to a subsequent conception, the risk of adverse pregnancy outcome such as preterm delivery and birth defects in the following pregnancy is increased (Smits and Essed, 2001).…”

Section: Introductionmentioning

confidence: 95%

Folate and vitamin B12 in relation to lactation: a 9-month postpartum follow-up study

et al. 2005

View full text Add to dashboard Cite

Objective: To investigate the relation between lactation and markers of folate and vitamin B12 (B12) deficiency in women with and without vitamin supplementation. Design: A 9-month follow-up study. Subjects and methods: Blood samples from 91 women, who gave birth to a single healthy child, were collected 3 weeks, 4 and 9 months postpartum and analysed for circulating level of homocysteine (tHcy), methylmalonic acid (MMA), folate and B12. The participants were categorized as exclusively, partly or not breast-feeding dependent on the degree of lactation 4 months postpartum. During follow-up, lifestyle factors were recorded by structured interviews. Results: Among 72 exclusively breast-feeding women, the median (10-90% percentile) tHcy was 5.8 (3.1-8.3) mmol/l 3 weeks postpartum, 6.1 (4.1-10.3) mmol/l 4 months postpartum and 5.3 (3.6-8.7) mmol/l 9 months postpartum. At 9 months postpartum, none of the women breast-fed exclusively. No significant change occurred in the concentration of B12 and folate. Exclusively breast-feeding women without vitamin supplementation had higher median tHcy than supplemented exclusively breast-feeding women 4 and 9 months postpartum (7.0 vs 5.4 mmol/l (Po0.001) and 5.8 vs 4.5 mmol/l (P ¼ 0.003), respectively). Six women had increased (415 mmol/l) tHcy; four of these were unsupplemented and exclusively breast-feeding. Conclusion: We found no overall indication of depletion of the folate and B12 stores during the lactation period in this population. However, folate-supplemented women had lower tHcy and higher folate levels, suggesting a beneficial effect of supplementation with folate throughout lactation. Sponsorship: The Biomedical Laboratory Scientist Education and Research Fund and LEO Pharma Research Foundation supported this study. DPC Scandinavia, Denmark donated reagents for the folate and tHcy analysis.

show abstract

Severe Vitamin B12 Deficiency in an Infant Associated With a Maternal Deficiency and a Strict Vegetarian Diet

Cited by 66 publications

References 10 publications

Vitamin B₁₂ and folate status in early pregnancy and cardiometabolic risk factors in the offspring at age 5–6 years: findings from the ABCD multi‐ethnic birth cohort

Vitamin B₁₂ and folate status in early pregnancy and cardiometabolic risk factors in the offspring at age 5–6 years: findings from the ABCD multi‐ethnic birth cohort

Vitamin B-12, folate, iron, and vitamin A concentrations in rural Indian children are associated with continued breastfeeding, complementary diet, and maternal nutrition

Folate and vitamin B12 in relation to lactation: a 9-month postpartum follow-up study

Contact Info

Product

Resources

About

Severe Vitamin B12 Deficiency in an Infant Associated With a Maternal Deficiency and a Strict Vegetarian Diet

Cited by 66 publications

References 10 publications

Vitamin B12 and folate status in early pregnancy and cardiometabolic risk factors in the offspring at age 5–6 years: findings from the ABCD multi‐ethnic birth cohort

Vitamin B12 and folate status in early pregnancy and cardiometabolic risk factors in the offspring at age 5–6 years: findings from the ABCD multi‐ethnic birth cohort

Vitamin B-12, folate, iron, and vitamin A concentrations in rural Indian children are associated with continued breastfeeding, complementary diet, and maternal nutrition

Folate and vitamin B12 in relation to lactation: a 9-month postpartum follow-up study

Contact Info

Product

Resources

About

Vitamin B₁₂ and folate status in early pregnancy and cardiometabolic risk factors in the offspring at age 5–6 years: findings from the ABCD multi‐ethnic birth cohort

Vitamin B₁₂ and folate status in early pregnancy and cardiometabolic risk factors in the offspring at age 5–6 years: findings from the ABCD multi‐ethnic birth cohort