The effect of infant vitamin B<sub>12</sub>supplementation on neurodevelopment: a follow-up of a randomised placebo-controlled trial in Nepal

Ulak, Manjeswori; Kvestad, Ingrid; Chandyo, Ram Krishna; Ranjitkar, Suman; Hysing, Mari; Schwinger, Catherine; Shrestha, Merina; Basnet, Sudha; Shrestha, Laxman; Strand, Tor A.

doi:10.1017/s0007114522000071

Cited by 6 publications

(3 citation statements)

References 25 publications

(47 reference statements)

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“…The main results of the project have been reported elsewhere. In short, the intervention resulted in a substantially improved vitamin B12 status but did not improve growth or neurodevelopment neither at 18-23 months [34] nor 30-47 months of age [35].…”

Section: Enrollment Procedures and Definitionsmentioning

confidence: 81%

The association between household biomass fuel use and leukocyte telomere length among toddlers in Bhaktapur, Nepal

Chandyo

Schwinger

Kvestad

et al. 2022

J Expo Sci Environ Epidemiol

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Background Biomass fuels are still in use for cooking by many households in resource poor countries such as Nepal and is a major source of household air pollution (HAP). Chronic exposure to HAP has been shown to be associated with shorter telomere length in adults. Objectives To measure the association between exposure related to household biomass fuel in infancy and leukocyte telomere length (LTL) at 18–23 months of age among 497 children from Bhaktapur, Nepal. Methods In a prospective cohort study design, we have collected information on household cooking fuel use and several clinical, anthropometric, demographic, and socioeconomic variables. We estimated the association between biomass fuel use and the relative LTL in multiple linear regression models. Results Most of the families (78%) reported liquified petroleum gas (LPG) as the primary cooking fuel, and 18.7% used biomass. The mean relative (SD) LTL was 1.03 (0.19). Children living in households using biomass fuel had on average 0.09 (95% CI: 0.05 to 0.13) units shorter LTL than children in households with no biomass fuel use. The observed association was unaltered after adjusting for relevant confounders. The association between LTL and biomass use was strongest among children from households with ≤2 rooms and without separate kitchen. Significance Exposure to biomass fuel use in early life might have consequences for longevity, and risk of chronic illnesses reflected in shortening of the telomeres. Our findings support the ongoing effort to reduce exposure to biomass fuel in low-resource settings. Impact statements Biomass for cooking is a leading source of household air pollution in low and middle-income countries, contributing to many chronic diseases and premature deaths. Chronic exposure to biomass fuel through oxidative stress and inflammation has been associated with a shortening of the telomeres, a “biological marker” of longevity. This prospective cohort study describes the association between household biomass fuel use and leukocyte telomere length among 497 toddlers. Leukocyte telomere length was significantly shorter among children living in households with biomass fuel than in children from homes where mainly LPG was used for cooking. Clinical Trial registration Clinicaltrials.gov: NCT02272842, registered October 21, 2014, Universal Trial Number: U1111-1161-5187 (September 8, 2014)

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Section: Enrollment Procedures and Definitionsmentioning

confidence: 81%

The association between household biomass fuel use and leukocyte telomere length among toddlers in Bhaktapur, Nepal

Chandyo

Schwinger

Kvestad

et al. 2022

J Expo Sci Environ Epidemiol

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“…Following enrolment, the family was visited by trained field workers to measure the home environment. The study children were subsequently invited every 12 months to the study clinic for follow up assessments of neurodevelopment and socio-emotional development until they were approximately 4 years old [ 27 ]. From the 600 enrolled children, we have developmental and cognitive scores at 4 timepoints in 527 children up to 4 years of age.…”

Section: Methodsmentioning

confidence: 99%

Social withdrawal behaviour in Nepalese infants and the relationship with future neurodevelopment; a longitudinal cohort study

Kvestad,

Ulak,

Ranjitkar

et al. 2024

BMC Pediatr

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Background Social withdrawal in infants may be a signal of distress and a precursor for non-optimal development. Objective To examine the relationship between infant social withdrawal and neurodevelopment up to 4 years in Nepalese children. Methods A total of 597 Nepalese infants 6–11 months old were assessed with the modified Alarm Distress Baby Scale (m-ADBB), and of these, 527 with the Bayley Scales of Infant and Toddler Development 3rd edition (Bayley-III) during early childhood, and the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-IV) and NEPSY-II subtests at 4 years. We examined whether social withdrawal defined by the m-ADBB was associated with neurodevelopmental scores in regression models. Results Children socially withdrawn in infancy had lower Bayley-III language scores (-2.6 (95% CI -4.5, -0.7)) in early childhood. This association seems to be driven by the expressive communication subscale (-0.7 (95% CI -1.0, -0.3)), but not the receptive communication subscale (-0.2 (95% CI -0.6, 0.1)). There were no differences in the other Bayley-III scores or the WPPSI-IV and NEPSY-II scores at 4 years in children who were socially withdrawn or not. Conclusion Social withdrawal in infancy was reflected in early language development but not cognitive functioning at 4 years.

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“…The study in Nepal enrolled 600 infants who were supplemented with 2 µg vitamin B 12 or a placebo daily for 1 year. While vitamin B 12 supplementation had a substantial effect on direct and indirect markers of B 12 status,14 no effects were observed for growth, neurodevelopment or other clinical outcomes 14–16. There are many potential reasons for the heterogeneity of these results.…”

Section: Introductionmentioning

confidence: 96%

Vitamin B₁₂status in infancy and the effect of a vitamin B₁₂injection in infants with subclinical vitamin B₁₂deficiency: study protocol for a register-based randomised controlled trial

et al. 2023

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IntroductionVitamin B12(cobalamin) is crucial for optimal child development and growth, yet deficiency is common worldwide. The aim of this study is twofold; (1) to describe vitamin B12status and the status of other micronutrients in Norwegian infants, and (2) in a randomised controlled trial (RCT), investigate the effect of vitamin B12supplementation on neurodevelopment in infants with subclinical vitamin B12deficiency.Methods and analysisInfant blood samples, collected at public healthcare clinics, are analysed for plasma cobalamin levels. Infants with plasma cobalamin <148 pmol/L are immediately treated with hydroxocobalamin and excluded from the RCT. Remaining infants (cobalamin ≥148 pmol/L) are randomly assigned (in a 1:1 ratio) to either a screening or a control group. In the screening group, baseline samples are immediately analysed for total homocysteine (tHcy), while in the control group, the baseline samples will be analysed after 12 months. Screening group infants with plasma tHcy >6.5 µmol/L, are given an intramuscular injection of hydroxocobalamin (400 µg). The primary outcomes are cognitive, language and motor development assessed using the Bayley Scales of Infant and Toddler Development at 12 months of age.Ethics and disseminationThe study has been approved by the Regional Committee for Medical and Health Research Ethics (ref: 186505). Investigators who meet the Vancouver requirements will be eligible for authorship and be responsible for dissemination of study findings. Results will extend current knowledge on consequences of subclinical vitamin B12deficiency during infancy and may inform future infant feeding recommendations.Trial registration numberNCT05005897.

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The effect of infant vitamin B₁₂supplementation on neurodevelopment: a follow-up of a randomised placebo-controlled trial in Nepal

Cited by 6 publications

References 25 publications

The association between household biomass fuel use and leukocyte telomere length among toddlers in Bhaktapur, Nepal

The association between household biomass fuel use and leukocyte telomere length among toddlers in Bhaktapur, Nepal

Social withdrawal behaviour in Nepalese infants and the relationship with future neurodevelopment; a longitudinal cohort study

Vitamin B₁₂status in infancy and the effect of a vitamin B₁₂injection in infants with subclinical vitamin B₁₂deficiency: study protocol for a register-based randomised controlled trial

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The effect of infant vitamin B12supplementation on neurodevelopment: a follow-up of a randomised placebo-controlled trial in Nepal

Cited by 6 publications

References 25 publications

The association between household biomass fuel use and leukocyte telomere length among toddlers in Bhaktapur, Nepal

The association between household biomass fuel use and leukocyte telomere length among toddlers in Bhaktapur, Nepal

Social withdrawal behaviour in Nepalese infants and the relationship with future neurodevelopment; a longitudinal cohort study

Vitamin B12status in infancy and the effect of a vitamin B12injection in infants with subclinical vitamin B12deficiency: study protocol for a register-based randomised controlled trial

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The effect of infant vitamin B₁₂supplementation on neurodevelopment: a follow-up of a randomised placebo-controlled trial in Nepal

Vitamin B₁₂status in infancy and the effect of a vitamin B₁₂injection in infants with subclinical vitamin B₁₂deficiency: study protocol for a register-based randomised controlled trial