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Gebelerde ve Yenidoğanlarda Vitamin B12 Düzeyinin Değerlendirilmesi

Year 2018, Volume: 6 Issue: 2, 53 - 60, 12.09.2018

Abstract

Amaç: Gebelerde vitamin B12 eksikliği yalnızca anneleri değil aynı zamanda bebeklerinide etkileyen önemli bir sağlık sorunudur. Her ne kadar vitamin B12 eksikliği tüm dünyada ve tüm yaş gruplarında görülse de, sosyoekonomik düzeyi düşük toplumlarda görülme sıklığı daha yüksektir.
Bu çalışmanın amacı, İstanbul’un sosyo-ekonomik düzeyi düşük bir bölgesi olan Bağcılar’da, gebe kadınların vitamin B12 düzeylerini belirlemek, annelerin vitamin B12 düzeyinin yenidoğan bebeklerin düzeyine etkisini ve Vitamin B12 eksikliği için risk faktörlerini belirlemektir.
Materyal ve Metot: Bu çalışma Mart 2016 ve Mart 2017 tarihleri arsında 73 gebe ve 71 yenidoğan üzerinde gerçekleştirildi. Yaş, cinsiyet, ağırlık, gebelik haftası, gebelik boyunca alınan kilo, vücut kitle endeksi, doğum sayısı, sosyo-ekonomik durum, diyet, gebelikte vitamin alımı kaydedildi. Tüm katılımcılardan tam kan sayımı ve vitamin B12 için kan örnekleri alındı. Gebe kadınlar ve yenidoğan bebekler Vitamin B12 düzeylerine göre sınıflandırıldı. Vitamin B12 eksikliği için risk faktörleri araştırıldı.
Bulgular: Gebe kadınların ortalama vitamin B12 düzeyi 172.96±103 pg/ml idi. B12 yetersizliği (<200 pg/ml) saptanan gruptaki kadınların oranı %74 olarak bulundu ve bunların %46’sının Vitamin B12 düzeyi 150pg/m’nin altında idi. Yeterli miktarda hayvansal gıda tüketen annelerin B12 düzeyi tüketmeyenlere göre anlamlı olarak yüksek bulundu (p=0.001). Bebeklerin ortalama vitamin B12 düzeyi 352.1±339.2 pg/ml olarak bulundu ve bebeklerin %26.6’sında B12 yetersizliği saptandı. Ayrıca bebeklerin %14’ünde B12 düzeyi 150 pg/ml’nin altında idi. Annelerin B12 düzeyi ile bebeklerin doğum haftası ve vücut ölçüleri arasında ilişki saptanmadı.
Sonuç: Bölgemizdeki gebe kadınlarda vitamin B12 eksikliğinin sıklığı oldukça yüksektir ve bunun temel nedeni yetersiz beslenmedir. Bu nedenle, sosyoekonomik düzeyi düşük bölgede yaşayan tüm kadınlarda gebelik başlangıcında vitamin B12 düzeyinin değerlendirilmesi uygun olacaktır.

References

  • 1-Allen LH. How common is vitamin B-12 deficiency? Am J Clin Nutr. 2009;89:693-6.
  • 2- Smith J, Coman D. Vitamin B12 Deficiency: an Update for the General Paediatrician. Pediat Therapeut. 2014:188. doi:10.4172/2161- 0665.1000188.
  • 3-Rasmussen SA, Fernhoff PM, Scanlon KS. Vitamin B12 deficiency in children and adolescents. J Pediatr. 2001;138:10-17.
  • 4-Hunt A, Harrington D, Robinson S. Vitamin B12 deficiency. BMJ. 2014;349:g5226.
  • 5-Dror DK, Allen LH. Effect of vitamin B12 deficiency on neurodevelopment in infants: current knowledge and possible mechanisms. Nutrition Reviews. 2008;66:250-56-Roumeliotis N, Dix D, Lipson A. Vitamin B12 deficiency in infants secondary to maternal causes. CMAJ. 2012;184:1593-8.
  • 7- Global database on Body Mass Index, WHO. Available from: http://apps.who.int/bmi/index.jsp?introPage=intro
  • 8- Institute of Medicine. Weight gain during pregnancy: reexamining the guidelines. Washington, DC: National Academies Press; 2009.
  • 9- De Benoist B. Conclusions of a WHO Technical Consultation on Folate and Vitamin B12 Deficiencies. Food Nutr Bull. 2008;29:238-44.
  • 13-10-Institute of Medicine of the National Academies of Science. Dietary reference intake for thiamine, riboflavin, niacin, vitamin B6, folate, vitamin B12, panthotenic acid, biotine and choline. Washington, DC: National Academies Press, 1998.
  • 10-11- Koebnick C, Heins UA, Dagnelie PC, Wickramasinghe SN, Ratnayaka ID, Hothorn T, et al. Longitudinal Concentrations of Vitamin B12 and Vitamin B12-binding Proteins during Uncomplicated Pregnancy. Clinical Chemistry. 2002;48:928-33.
  • 11-12- Devalia V, Hamilton MS, M. Molloy AM; British Committee for Standards in Haematology. Guidelines for the diagnosis and treatment of cobalamin and folate disorders. Br J Haematol. 2014;166: 496–513
  • 12-13- Molloy AM, Kirke PN, Brody LC, Scott JM, Mills JL. Effects of folate and vitamin B12 deficiencies during pregnancy on fetal, infant, and child development. Food Nutr Bull. 2008;29:S101-11; discussion S112-5.
  • 14-Ray JG, Goodman J, O'Mahoney PR, Mamdani MM, Jiang D. High rate of maternal vitamin B12 deficiency nearly a decade after Canadian folic acid flour fortification. QJM. 2008;101:475-7. doi: 10.1093/qjmed/hcn031
  • 15-García-Casal MN, Osorio C, Landaeta M, Leets I, Matus P, Fazzino F, et al. High prevalence of folic acid and vitamin B12 deficiencies in infants, children, adolescents and pregnant women in Venezuela. Eur J Clin Nutr. 2005;59:1064-70.
  • 16- Vitamin B (12) intake and status in early pregnancy among urban South Indian women. Samuel TM, Duggan C, Thomas T, Bosch R, Rajendran R, Virtanen SM, et al. Ann Nutr Metab. 2013;62:113-22. doi: 10.1159/000345589.
  • 17-VanderJagt DJ, Ujah IAO, Ikeh EI, Bryant J, Pam V, Hilgart A, et al. Assessment of the Vitamin B12 Status of Pregnant Women in Nigeria Using Plasma Holotranscobalamin. ISRN Obstet and Gynecol. 2011;2011:365894. doi:10.5402/2011/365894.
  • 18-. Sukumar N, Rafnsson SB, Kandala NB, Bhopal R, Yajnik CS, Saravanan P. Prevalence of vitamin B-12 insufficiency during pregnancy and its effect on offspring birth weight: a systematic review and meta-analysis. Am J Clin Nutr. 2016;103:1232-51. doi: 10.3945/ajcn.115.123083.
  • 19-Koc A, Kocyigit A, Soran M, Demir N, Sevinc E, Erel O, et al. High frequency of maternal vitamin B12 deficiency as an important cause of infantile vitamin B12 deficiency in Sanliurfa province of Turkey. Eur J Nutr. 2006;45:291-7.
  • 20- Önal H, Adal E, Öner T, Önal Z, Ahmet Aydın A. An important problem in developing countries: maternal and neonatal vitamin B12 deficiency. Turk Arch Ped. 2010;45:242-5. doi: 10.4274/tpa.45.242
  • 21-Halicioglu O, Sutcuoglu S, Koc F, Ozturk C, Albudak E, Colak A, et al.. Vitamin B12 and folate statuses are associated with diet in pregnant women, but not with anthropometric measurements in term newborns. J Matern Fetal Neonatal Med. 2012;25:1618-21. doi: 10.3109/14767058.2011.648244
  • 22- Yılmaz Keskin E, Demir B, İğde M, Öksüz BG. Prevalence of Vitamin B12 Deficiency among Pregnant Women in Samsun Province of Turkey. Cukurova Med J. 2014;39:840-7.
  • 23-Muthayya S, Kurpad AV, Duggan CP, Bosch RJ, Dwarkanath P, Mhaskar A, et al. Low maternal vitamin B12 status is associated with intrauterine growth retardation in urban South Indians. Eur J Clin Nutr. 2006;60:791-801.
  • 24-Rogne T, Tielemans MJ, Foong-Fong Chong M, Yajnik CS, Krishnaveni GV, Poston L, et al. Maternal vitamin B12 in pregnancy and risk of preterm birth and low birth weight: A systematic review and individual participant data meta-analysis. Am J Epidemiol. 2017;185:212-23. . doi: 10.1093/aje/kww212
  • 25-Chen LW, Lim AL, Colega M, Tint MT, Aris IM, Tan CS, et al. Maternal folate status, but not that of vitamins B-12 or B-6, is associated with gestational age and preterm birth risk in a multiethnic Asian population. J Nutr. 2015;145:113-20. doi: 10.3945/jn.114.196352.

Assessment of The Vitamın B12 Status of Pregnant Women and Their Infants

Year 2018, Volume: 6 Issue: 2, 53 - 60, 12.09.2018

Abstract

Abstract
Aim: Vitamin B12 deficiency is an important problem in
pregnancy because it affects not only mothers but also
their infants. Although vitamin B12 deficiency is seen all
over the world and all age groups, its frequency is much
higher in population which has low socio-economic level.
The aim of this study was to evaluate the maternal vitamin
B12 status and their effect on neonatal vitamin B12 status
and to detect risk factors for vitamin B12 deficiency in
Bağcılar where is a low socio-economic region in Istanbul.
Materials and Methods: A total of 71 pregnant women and
71 infants were included in this study between March 2016
and March 2017. Age, gender, weight, gestational age,
weight gain during pregnancy, body mass index (BMI),
number of parity, socio-economic status, diet, daily vitamin
intake were recorded. Blood samples for whole blood
count and vitamin B12 were taken all subjects. The
pregnant women and newborns were divided into groups
based on their vitamin B12 levels. The risk factors were
analyzed for vitamin B12 deficiency.
Results: The mean vitamin B12 level was 172.23±102
pg/ml for pregnant women. The number of pregnant
women in deficient group (<200 pg/ml) were 73% and 46%
of the mothers had a serum vitamin B12 level lower than
150 pg/ml. B12 level of pregnant women those who have
consumed sufficient amount of animal products were found
as significantly higher than the consumed insufficient
(p=0.001). The mean vitamin B12 level of infants was
found as 352.1±339.2 pg/ml and the number of infants in
deficient group were 26.6%. Also, 14% of the infants had a
serum vitamin B12 level lower than 150 pg/ml. There was
no correlation between the mothers’ B12 level and
newborns’ body measurements and gestational age
Conclusion: The prevalence of vitamin B12 deficiency in
pregnant women in our region was very high and mainly
cause was sub-optimal nutrition. Therefore, we suggest
that the vitamin B12 status may be assess at the beginning
of pregnancy in all women live in low socioeconomic
region status.

References

  • 1-Allen LH. How common is vitamin B-12 deficiency? Am J Clin Nutr. 2009;89:693-6.
  • 2- Smith J, Coman D. Vitamin B12 Deficiency: an Update for the General Paediatrician. Pediat Therapeut. 2014:188. doi:10.4172/2161- 0665.1000188.
  • 3-Rasmussen SA, Fernhoff PM, Scanlon KS. Vitamin B12 deficiency in children and adolescents. J Pediatr. 2001;138:10-17.
  • 4-Hunt A, Harrington D, Robinson S. Vitamin B12 deficiency. BMJ. 2014;349:g5226.
  • 5-Dror DK, Allen LH. Effect of vitamin B12 deficiency on neurodevelopment in infants: current knowledge and possible mechanisms. Nutrition Reviews. 2008;66:250-56-Roumeliotis N, Dix D, Lipson A. Vitamin B12 deficiency in infants secondary to maternal causes. CMAJ. 2012;184:1593-8.
  • 7- Global database on Body Mass Index, WHO. Available from: http://apps.who.int/bmi/index.jsp?introPage=intro
  • 8- Institute of Medicine. Weight gain during pregnancy: reexamining the guidelines. Washington, DC: National Academies Press; 2009.
  • 9- De Benoist B. Conclusions of a WHO Technical Consultation on Folate and Vitamin B12 Deficiencies. Food Nutr Bull. 2008;29:238-44.
  • 13-10-Institute of Medicine of the National Academies of Science. Dietary reference intake for thiamine, riboflavin, niacin, vitamin B6, folate, vitamin B12, panthotenic acid, biotine and choline. Washington, DC: National Academies Press, 1998.
  • 10-11- Koebnick C, Heins UA, Dagnelie PC, Wickramasinghe SN, Ratnayaka ID, Hothorn T, et al. Longitudinal Concentrations of Vitamin B12 and Vitamin B12-binding Proteins during Uncomplicated Pregnancy. Clinical Chemistry. 2002;48:928-33.
  • 11-12- Devalia V, Hamilton MS, M. Molloy AM; British Committee for Standards in Haematology. Guidelines for the diagnosis and treatment of cobalamin and folate disorders. Br J Haematol. 2014;166: 496–513
  • 12-13- Molloy AM, Kirke PN, Brody LC, Scott JM, Mills JL. Effects of folate and vitamin B12 deficiencies during pregnancy on fetal, infant, and child development. Food Nutr Bull. 2008;29:S101-11; discussion S112-5.
  • 14-Ray JG, Goodman J, O'Mahoney PR, Mamdani MM, Jiang D. High rate of maternal vitamin B12 deficiency nearly a decade after Canadian folic acid flour fortification. QJM. 2008;101:475-7. doi: 10.1093/qjmed/hcn031
  • 15-García-Casal MN, Osorio C, Landaeta M, Leets I, Matus P, Fazzino F, et al. High prevalence of folic acid and vitamin B12 deficiencies in infants, children, adolescents and pregnant women in Venezuela. Eur J Clin Nutr. 2005;59:1064-70.
  • 16- Vitamin B (12) intake and status in early pregnancy among urban South Indian women. Samuel TM, Duggan C, Thomas T, Bosch R, Rajendran R, Virtanen SM, et al. Ann Nutr Metab. 2013;62:113-22. doi: 10.1159/000345589.
  • 17-VanderJagt DJ, Ujah IAO, Ikeh EI, Bryant J, Pam V, Hilgart A, et al. Assessment of the Vitamin B12 Status of Pregnant Women in Nigeria Using Plasma Holotranscobalamin. ISRN Obstet and Gynecol. 2011;2011:365894. doi:10.5402/2011/365894.
  • 18-. Sukumar N, Rafnsson SB, Kandala NB, Bhopal R, Yajnik CS, Saravanan P. Prevalence of vitamin B-12 insufficiency during pregnancy and its effect on offspring birth weight: a systematic review and meta-analysis. Am J Clin Nutr. 2016;103:1232-51. doi: 10.3945/ajcn.115.123083.
  • 19-Koc A, Kocyigit A, Soran M, Demir N, Sevinc E, Erel O, et al. High frequency of maternal vitamin B12 deficiency as an important cause of infantile vitamin B12 deficiency in Sanliurfa province of Turkey. Eur J Nutr. 2006;45:291-7.
  • 20- Önal H, Adal E, Öner T, Önal Z, Ahmet Aydın A. An important problem in developing countries: maternal and neonatal vitamin B12 deficiency. Turk Arch Ped. 2010;45:242-5. doi: 10.4274/tpa.45.242
  • 21-Halicioglu O, Sutcuoglu S, Koc F, Ozturk C, Albudak E, Colak A, et al.. Vitamin B12 and folate statuses are associated with diet in pregnant women, but not with anthropometric measurements in term newborns. J Matern Fetal Neonatal Med. 2012;25:1618-21. doi: 10.3109/14767058.2011.648244
  • 22- Yılmaz Keskin E, Demir B, İğde M, Öksüz BG. Prevalence of Vitamin B12 Deficiency among Pregnant Women in Samsun Province of Turkey. Cukurova Med J. 2014;39:840-7.
  • 23-Muthayya S, Kurpad AV, Duggan CP, Bosch RJ, Dwarkanath P, Mhaskar A, et al. Low maternal vitamin B12 status is associated with intrauterine growth retardation in urban South Indians. Eur J Clin Nutr. 2006;60:791-801.
  • 24-Rogne T, Tielemans MJ, Foong-Fong Chong M, Yajnik CS, Krishnaveni GV, Poston L, et al. Maternal vitamin B12 in pregnancy and risk of preterm birth and low birth weight: A systematic review and individual participant data meta-analysis. Am J Epidemiol. 2017;185:212-23. . doi: 10.1093/aje/kww212
  • 25-Chen LW, Lim AL, Colega M, Tint MT, Aris IM, Tan CS, et al. Maternal folate status, but not that of vitamins B-12 or B-6, is associated with gestational age and preterm birth risk in a multiethnic Asian population. J Nutr. 2015;145:113-20. doi: 10.3945/jn.114.196352.
There are 24 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Orginal Article
Authors

Abdurrahman Avar Özdemir 0000-0002-8968-8889

Yasemin Ercan Gündemir This is me 0000-0003-4414-9512

Publication Date September 12, 2018
Published in Issue Year 2018 Volume: 6 Issue: 2

Cite

APA Özdemir, A. A., & Ercan Gündemir, Y. (2018). Assessment of The Vitamın B12 Status of Pregnant Women and Their Infants. Namık Kemal Tıp Dergisi, 6(2), 53-60.
AMA Özdemir AA, Ercan Gündemir Y. Assessment of The Vitamın B12 Status of Pregnant Women and Their Infants. NKMJ. September 2018;6(2):53-60.
Chicago Özdemir, Abdurrahman Avar, and Yasemin Ercan Gündemir. “Assessment of The Vitamın B12 Status of Pregnant Women and Their Infants”. Namık Kemal Tıp Dergisi 6, no. 2 (September 2018): 53-60.
EndNote Özdemir AA, Ercan Gündemir Y (September 1, 2018) Assessment of The Vitamın B12 Status of Pregnant Women and Their Infants. Namık Kemal Tıp Dergisi 6 2 53–60.
IEEE A. A. Özdemir and Y. Ercan Gündemir, “Assessment of The Vitamın B12 Status of Pregnant Women and Their Infants”, NKMJ, vol. 6, no. 2, pp. 53–60, 2018.
ISNAD Özdemir, Abdurrahman Avar - Ercan Gündemir, Yasemin. “Assessment of The Vitamın B12 Status of Pregnant Women and Their Infants”. Namık Kemal Tıp Dergisi 6/2 (September 2018), 53-60.
JAMA Özdemir AA, Ercan Gündemir Y. Assessment of The Vitamın B12 Status of Pregnant Women and Their Infants. NKMJ. 2018;6:53–60.
MLA Özdemir, Abdurrahman Avar and Yasemin Ercan Gündemir. “Assessment of The Vitamın B12 Status of Pregnant Women and Their Infants”. Namık Kemal Tıp Dergisi, vol. 6, no. 2, 2018, pp. 53-60.
Vancouver Özdemir AA, Ercan Gündemir Y. Assessment of The Vitamın B12 Status of Pregnant Women and Their Infants. NKMJ. 2018;6(2):53-60.