Cobalamin status during normal pregnancy and postpartum: a longitudinal study comprising 406 Danish women.
OBJECTIVE
To assess cobalamin (vitamin B(12)) status during normal pregnancy and postpartum in a longitudinal setting.


METHODS
This study was performed in 1995-1996. It comprised 406 healthy, pregnant Danish Caucasian women, living in Copenhagen County. Cobalamin status, i.e. plasma (P-) cobalamin, P-methylmalonic acid and P-homocysteine was measured at 18, 32 and 39 wk gestation and 8 wk postpartum during lactation.


RESULTS
P-cobalamin showed a gradual, significant decline during pregnancy (P < 0.0001) followed by a significant increase postpartum (P < 0.0001); at 18, 32, 39 wk gestation and 8 wk postpartum median values were 225, 172, 161 and 319 pmol/L, respectively. P-methylmalonic displayed a gradual, significant increase during pregnancy as well as postpartum (P < 0.001) with median values of 0.11, 0.13, 0.14, and 0.16 micromol/L, respectively. P-homocysteine demonstrated a significant increase during pregnancy and postpartum (P < 0.001). The frequency of P-cobalamin values <150 pmol/L increased during pregnancy from 15% at 18 wk to 43% at 39 wk gestation and subsequently declined to 3% postpartum.


CONCLUSIONS
Low cobalamin status may occur among pregnant women, especially in late pregnancy. The recommendations for periconceptional vitamin B(12) supplementation should be reconsidered.
Department of Obstetrics, Gentofte Hospital, University of Copenhagen, Denmark. milman@rh.dk
Nils
N
Milman
Keld-Erik
KE
Byg
Thomas
T
Bergholt
Lisbeth
L
Eriksen
Anne-Mette
AM
Hvas
D000328:Adult; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006454:Hemoglobins / Q000032:analysis; D006710:Homocysteine / Q000097:blood; D006801:Humans; D007231:Infant, Newborn; D008764:Methylmalonic Acid / Q000097:blood; D049590:Postpartum Period / Q000097:blood*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D012016:Reference Values; D014805:Vitamin B 12 / Q000097:blood*; D014806:Vitamin B 12 Deficiency / Q000453:epidemiology
D006454:Hemoglobins; D006710:Homocysteine; D008764:Methylmalonic Acid; D014805:Vitamin B 12