title: Vitamin B12status in pregnant women and their infants in South India.
abstract: Vitamin B12deficiency during pregnancy has been associated with increased risk of adverse perinatal outcomes. However, few studies have investigated the burden and determinants of vitamin B12status in young infants. This study was conducted to determine the associations between maternal and infant vitamin B12status.
  
  
  
  Pregnant women participating in a vitamin B12supplementation trial in Bangalore, India, were randomized to receive vitamin B12(50 μg) or placebo supplementation daily during pregnancy through 6 weeks postpartum. All women received 60 mg of iron and 500 μg of folic acid daily during pregnancy, as per standard of care. This prospective analysis was conducted to determine the associations between maternal vitamin B12biomarkers (that is, plasma vitamin B12, methylmalonic acid (MMA) and tHcy) during each trimester with infant vitamin B12status (n=77) at 6 weeks of age.
  
  
  
  At baseline (⩽14 weeks of gestation), 51% of mothers were vitamin B12deficient (vitamin B12<150 pmol/l) and 43% had impaired vitamin B12status (vitamin B12<150 pmol/l and MMA>0.26 μmol/l); 44% of infants were vitamin B12deficient at 6 weeks of age. After adjusting for vitamin B12supplementation, higher vitamin B12concentrations in each trimester were associated with increased infant vitamin B12concentrations and lower risk of vitamin B12deficiency in infants (P<0.05). After adjusting for vitamin B12supplementation, infants born to women with vitamin B12deficiency had a twofold greater risk of vitamin B12deficiency (P<0.01). Higher maternal folate concentrations also predicted lower risk of vitamin B12deficiency in infants (P<0.05). Impaired maternal vitamin B12status, which combined both circulating and functional biomarkers, was the single best predictor of infant vitamin B12status.
  
  
  
  Impaired maternal vitamin B12status throughout pregnancy predicted higher risk of vitamin B12deficiency in infants, after adjusting for vitamin B12supplementation. Future interventions are needed to improve vitamin B12status periconceptionally, and to ensure optimal vitamin B12status and health outcomes in pregnant women and their children.
authors.affiliation: Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA.|Division of Nutrition, St. John's Research Institute, Bangalore, India.
authors.forename: J L
authors.initials: JL
authors.lastname: Finkelstein
authors.affiliation: Division of Nutrition, St. John's Research Institute, Bangalore, India.|Department of Physiology, St. John's Medical College, Bangalore, India.
authors.forename: A V
authors.initials: AV
authors.lastname: Kurpad
authors.affiliation: Division of Epidemiology, Biostatistics and Population Health, St. John's Research Institute, Bangalore, India.
authors.forename: T
authors.initials: T
authors.lastname: Thomas
authors.affiliation: Division of Mental Health and Neurosciences, St. John's Research Institute, Bangalore, India.|Department of Psychiatry, St. John's Medical College, Bangalore, India.
authors.forename: K
authors.initials: K
authors.lastname: Srinivasan
authors.affiliation: Division of Nutrition, St. John's Research Institute, Bangalore, India.|Department of Nutrition, Harvard T.H. Chan School of Public Health and Center for Nutrition, Boston Children's Hospital, Boston, MA, USA.
authors.forename: C
authors.initials: C
authors.lastname: Duggan
mesh_terms: D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D007194:India; D007231:Infant, Newborn / Q000097:blood*; D008297:Male; D008764:Methylmalonic Acid / Q000097:blood; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000188:drug therapy*; D011264:Pregnancy Trimesters; D011446:Prospective Studies; D016896:Treatment Outcome; D014805:Vitamin B 12 / Q000097:blood / Q000627:therapeutic use*; D014806:Vitamin B 12 Deficiency / Q000097:blood / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D008764:Methylmalonic Acid; D014805:Vitamin B 12