title: Effects of maternal vitamin B12 supplementation on early infant neurocognitive outcomes: a randomized controlled clinical trial.
abstract: Maternal nutritional status during pregnancy impacts fetal brain development. Vitamin B12 plays a vital role in neuronal development. However, findings from studies on the association between maternal B12 status and child cognitive functions have been inconsistent. We performed a randomized, placebo-controlled clinical trial of oral B12 supplementation (50 µg) beginning at <14 weeks of gestation through a 6-week post-partum. In the present study, we report the effects of maternal B12 supplementation on cognitive development in infants at 9 months of age on Bayley Scales of Infant Development-III (BSID-III). One hundred eighty-three pregnant women received vitamin B12, and 183 received placebo. Nine-month BSID-III development score was available in 178 infants. There were no significant differences in maternal sociodemographic characteristics and baseline biochemical measures between infants who underwent BSID-III evaluation and infants who were not evaluated. There were no significant differences in any of the subscales of BSID-III between infants born to mothers who received B12 supplementation (n = 78) vs. placebo (n = 100). On multiple regression analysis, elevated maternal total homocysteine (tHcy) levels adjusted for treatment group, birthweight, parity, income and home environment at second trimester of pregnancy were significantly negatively associated with expressive language (β = 3.13 points, P < 0.001), and in third trimester of pregnancy with expressive language (β = -2.29 points, P < 0.001) and fine motor (β = -1.41 points, P = 0.005) domains of BSID-III. While no significant effects of maternal B12 supplementation were seen on cognitive development in infants at 9 months of age, elevated maternal tHcy levels were associated with poorer cognitive performance in some of the subdomains of BSID-III. In pregnant women with elevated tHcy levels and or B12 deficiencies, it may be worthwhile to study the impact of longer term maternal supplementation on infant cognitive outcomes.
authors.affiliation: Division of Mental Health and Neurosciences, St. John's Research Institute, Bengaluru, Karnataka, India.|Department of Psychiatry, St. John's Medical College, Bangalore, Karnataka, India.
authors.forename: Krishnamachari
authors.initials: K
authors.lastname: Srinivasan
authors.affiliation: Division of Epidemiology, Biostatistics and Population Health, St. John's Research Institute, Bangalore, Karnataka, India.
authors.forename: Tinku
authors.initials: T
authors.lastname: Thomas
authors.affiliation: Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.
authors.forename: Aruna Rose Mary
authors.initials: AR
authors.lastname: Kapanee
authors.affiliation: Division of Mental Health and Neurosciences, St. John's Research Institute, Bengaluru, Karnataka, India.
authors.forename: Asha
authors.initials: A
authors.lastname: Ramthal
authors.affiliation: Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: David C
authors.initials: DC
authors.lastname: Bellinger
authors.affiliation: Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts, USA.
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Bosch
authors.affiliation: Division of Nutrition, St. John's Research Institute, Bangalore, Karnataka, India.|Department of Physiology, St. John's Medical College, Bangalore, Karnataka, India.
authors.forename: Anura V
authors.initials: AV
authors.lastname: Kurpad
authors.affiliation: Division of Nutrition, St. John's Research Institute, Bangalore, Karnataka, India.|Center for Nutrition, Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, Massachusetts, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Duggan
mesh_terms: D000328:Adult; D001921:Brain / Q000196:embryology / Q000254:growth & development*; D002657:Child Development; D003071:Cognition; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D047109:Fetal Development; D006710:Homocysteine / Q000097:blood; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D016014:Linear Models; D039382:Maternal Nutritional Physiological Phenomena; D018977:Micronutrients / Q000008:administration & dosage / Q000097:blood; D009752:Nutritional Status; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D015995:Prevalence; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D014805:Vitamin B 12 / Q000008:administration & dosage*; D014806:Vitamin B 12 Deficiency / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D018977:Micronutrients; D006710:Homocysteine; D014805:Vitamin B 12
keywords: antenatal nutrition; cognitive function; homocysteine; infants; maternal micronutrients; maternal vitamin B12