IInvestigation of the Effects of First Trimester Maternal Hemoglobin and B12 Vitamin Levels on Newborn Anthropometric Measurements

Öz

AIntroduction: While iron deficiency anemia is closely associated with negative outcomes such as low birth weight, preterm birth, increased maternal-perinatal mortality and morbidity, retardation in motor-mental development in the newborn and advanced childhood, hemoglobin concentrations are decreased due to hemodilution and negative iron balance during pregnancy. In addition, increased need for vitamin B12 during pregnancy and vitamin B12 deficiency, lead to risky pregnancy and megaloblastic anemia in mothers which is associated with neurodevelopmental retardation in newborns. Aim: In this study, it was aimed to evaluate the relationship between serum Hb levels and vitamin B12 levels during pregnancy in the postnatal period and anthropometric measurements of newborns. Materials and methods: The study was conducted with 126 participants between the ages of 19-43. In the first trimester of pregnancy, serum Hb levels and vitamin B12 levels, birth weight, birth length and head circumference of newborns were evaluated. In addition, maternal age, number of births and gestational week were evaluated. Results and recommendations: Although there was a statistically significant relationship between maternal vitamin B12 levels and newborn birth weight and head circumference (p<0.05), no relationship was found between maternal vitamin B12 levels and birth length (p>0.05). In conclusion, it was determined that maternal first trimester B12 deficiency was associated with prematurity and other and anthropometric measurements in the newborn.

Anahtar Kelimeler

• Anemia
• Vitamin B12 Deficiency
• Anthropometry

Birinci Trimester Maternal Hemoglobin ve B12 Vitamini Düzeylerinin Yenidoğan Antropometrik Ölçümleri Üzerine Etkilerinin İncelenmesi

Öz

Giriş: Demir eksikliği anemisi; düşük doğum ağırlığı, preterm doğum, maternal-perinatal mortalite ve morbitide artışı, yenidoğan ve ileri çocukluk döneminde motor-mental gelişmede gerilik gibi olumsuz sonuçlar ile yakından ilişkilendirilirken, gebelikte hemodilüsyon ve negatif demir dengesi sebebi ile hemoglobin konsantrasyonlarında azalma görülmektedir. Bunun yanında gebelikte B12 vitamini ihtiyacının artması ve B12 vitamini yetersizliği, annelerde riskli gebelik ve megaloblastik anemiye yol açarken, yenidoğanlarda nörogelişimsel gerilik ile ilişkilendirilmektedir. Amaç: Bu bilgiler ışığında bu çalışmada postnatal dönemde gebelikte serum Hb düzeyleri ile vitamin B12 düzeyleri ile yenidoğanların antropometrik ölçümleri arasındaki ilişkiyi değerlendirmek amaçlanmıştır. Gereç ve Yöntem: Çalışma 19-43 yaş arası 126 birey ile yürütüldü. Gebeliğin ilk trimesterinde serum Hb düzeyleri ve vitamin B12 düzeyleri ile yenidoğanların doğum ağırlığı, doğum uzunluğu ve baş çevresi uzunluğu değerlendirildi. Ayrıca anne yaşı, doğum sayısı ve gebelik haftası değerlendirildi. Sonuç ve Öneriler: Maternal vitamin B12 düzeyleri ile yenidoğan doğum ağırlığı ve baş çevresi uzunluğu arasında istatistiksel olarak anlamlı ilişki bulunmasına rağmen (p<0.05), maternal vitamin B12 düzeyleri ile doğum uzunluğu arasında ilişki bulunmadı (p>0.05). Çalışmada maternal birinci trimester B12 eksikliğinin yenidoğanda prematürite ve diğer ve antropometrik ölçümleri ile ilişkili olduğu belirlendi.

Anahtar Kelimeler

• Anemi,
• B12 Vitamini Eksikliği
• Antropometri

Kaynakça

1. Bakacak, M., Avci, F., Ercan, O., Köstü, B., Serin, S., Kiran, G., Bakacak, Z. (2015). The effect of maternal hemoglobin concentration on fetal birth weight according to trimesters. The Journal of Maternal-Fetal & Neonatal Medicine, 28(17), 2106-2110.
2. Basu, S., Kumar, D., Anupurba, S., Verma, A., Kumar, A. (2018). Effect of maternal iron deficiency anemia on fetal neural development. Journal of Perinatology, 38(3), 233-239.
3. Behal M, Vinayak R, Sharma A. (2018). Maternal anaemia and its effects on neonatal anthropometric parameters in patients attending a tertiary care institute of Solan, Himachal Pradesh, India. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 7(2), 553.
4. Chen, L.-W., Lim, A. L., Colega, M., Tint, M.-T., Aris, I. M., Tan, C. S., Kwek, K. (2015). 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. The Journal of Nutrition, 145(1), 113-120.
5. Çağlayan, E. K., Küçük, Ö., Göçmen, A. Y., Seçkin, L., Aktulay, A., Üstün, Y. E. (2016). Sixth-Month Perinatal Outcomes of Anemic Pregnancies. Gynecology Obstetrics & Reproductive Medicine, 20(2), 68-72.
6. Dündar, Ö., Çiftpınar, T., Tütüncü, L., Ergür, A. R., Atay, M. V., Müngen, E., Yergök, Y. Z. (2010). İkinci trimester maternal hemoglobin seviyesinin doğum ağırlığı ve haftasına etkisi. Trakya Üniversitesi Tıp Fakültesi Dergisi, 27(2), 156-160.
7. Dwarkanath, P., Barzilay, J. R., Thomas, T., Thomas, A., Bhat, S., Kurpad, A. V. (2013). High folate and low vitamin B-12 intakes during pregnancy are associated with small-for-gestational age infants in South Indian women: a prospective observational cohort study. American Journal of Clinical Nutrition, 98(6), 1450-1458.
8. Erdem, A., Erdem, M., Arslan, M., Yazici, G., Eskandari, R., Himmetoglu, Ö. (2002). The effect of maternal anemia and iron deficiency on fetal erythropoiesis: comparison between serum erythropoietin, hemoglobin and ferritin levels in mothers and newborns. The Journal of Maternal-Fetal & Neonatal Medicine, 11(5), 329-332.

9. Finkelstein JL, Fothergill A, Krisher JT, Thomas T, Kurpad AV, Dwarkanath P. (2021). Maternal vitamin B12 deficiency and perinatal outcomes in southern India. PloS One, 16(4), e0248145. Fondjo LA, Addai Mensah O, Annani-Akollor ME, Quarshie JT, Boateng AA, Assafuah SE, Owiredu EW. (2020). A multicenter study of the prevalence and risk factors of malaria and anemia among pregnant women at first antenatal care visit in Ghana. Plos One, 15(8), e0238077.
10. Gill, S. V., May-Benson, T. A., Teasdale, A., Munsell, E. G. (2013). Birth and developmental correlates of birth weight in a sample of children with potential sensory processing disorder. Bmc Pediatrics, 13(1), 29.
11. Guideline, W. (2012). Daily iron and folic acid supplementation in pregnant women. Geneva: World Health Organization, 27.
12. Haider, B. A., Olofin, I., Wang, M., Spiegelman, D., Ezzati, M., Fawzi, W. W. (2013). Anaemia, prenatal iron use, and risk of adverse pregnancy outcomes: systematic review and meta-analysis. Bmj, 346.
13. Halicioglu, O., Sutcuoglu, S., Koc, F., Ozturk, C., Albudak, E., Colak, A., Asik Akman, S. (2012). Vitamin B12 and folate statuses are associated with diet in pregnant women, but not with anthropometric measurements in term newborns. The Journal of Maternal-Fetal & Neonatal Medicine, 25(9), 1618-1621.
14. Harju, M., Pekkanen, J., Heinonen, S., Keski‐Nisula, L. (2018). Maternal anemia during pregnancy and slightly higher risk of asthma in male offspring. Journal of Obstetrics and Gynaecology Research, 44(4), 614-622.
15. Hogeveen, M., Blom, H. J., van der Heijden, E. H., Semmekrot, B. A., Sporken, J. M., Ueland, P. M., den Heijer, M. (2010). Maternal homocysteine and related B vitamins as risk factors for low birthweight. American Journal of Obstetrics and Gynecology, 202(6), 572. e571-572. e576.
16. Jeruszka-Bielak, M., Isman, C., Schroder, T. H., Li, W., Green, T. J., Lamers, Y. (2017). South Asian ethnicity is related to the highest risk of vitamin B12 deficiency in pregnant Canadian women. Nutrients, 9(4), 317.
17. Jour, A. (2017). The Official Publication of Perinatal Medicine Foundation, Turkish Perinatology Society and Turkish Society of Ultrasound in Obstetrics and Gynecology.
18. Kabaran, S., Ayaz, A. (2013). Maternal ve fetal sağlık üzerinde B12, folik asit, A, D, E ve C vitaminlerinin etkileri. Türk Hijyen ve Deneysel Biyoloji Dergisi, 70(2), 103-112.
19. Kandauda IC, Tennakoon S, Rathnayake PM, Maduwage K, Gunathilake T. (2020). Prevalence and aetiology of anaemia in pregnant women attending a tertiary care unit in sri lanka, and its effect on the mother and newborn. Sri Lanka Journal of Medicine, 29(2).
20. Koc, A., Kocyigit, A., Soran, M., Demir, N., Sevinc, E., Erel, O., Mil, Z. (2006). High frequency of maternal vitamin B 12 deficiency as an important cause of infantile vitamin B 12 deficiency in Sanliurfa province of Turkey. European Journal of Nutrition, 45(5), 291-297.
21. Köse, E. D. P., Mihmanlı, V., Demirayak, G., Nalbant, H., Özalp, M., Gökçen, İ. (2016). Üçüncü Trimester Maternal Hemoglobin Değerinin Fetal Ağırlık ve Doğum Haftasına Etkisi. Okmeydanı Tıp Dergisi, 32(4), 204-210.
22. Levy, A., Fraser, D., Katz, M., Mazor, M., Sheiner, E. (2005). Maternal anemia during pregnancy is an independent risk factor for low birthweight and preterm delivery. European Journal of Obstetrics & Gynecology and Reproductive Biology, 122(2), 182-186.
23. Organization, W. H. (2011). Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity.
24. Rahmati, S., Delpishe, A., Azami, M., Ahmadi, M. R. H., Sayehmiri, K. (2017). Maternal Anemia during pregnancy and infant low birth weight: A systematic review and Meta-analysis. International Journal of Reproductive Biomedicine, 15(3), 125.
25. Ren, A., Wang, J., Ye, R., Li, S., Liu, J., Li, Z. (2007). Low first-trimester hemoglobin and low birth weight, preterm birth and small for gestational age newborns. International Journal of Gynecology & Obstetrics, 98(2), 124-128.
26. Sekhavat, L., Davar, R., Hosseinidezoki, S. (2011). Relationship between maternal hemoglobin concentration and neonatal birth weight. Hematology, 16(6), 373-376.
27. Shah T, Warsi J, Laghari Z. Effect of Maternal Anemia on the Anthropometric Indices of Newborn. (2020). Journal of Liaquat University of Medical & Health Sciences, 19(3), 191-194.
28. Siu, A. L. (2015). Screening for iron deficiency anemia and iron supplementation in pregnant women to improve maternal health and birth outcomes: US Preventive Services Task Force Recommendation Statement. Annals of Internal Medicine, 163(7), 529-536.
29. WHO. (2015). The global prevalence of anaemia in 2011. Geneva: World Health Organization. Wright, S., Earland, D., Sakhuja, S., Junkins, A., Franklin, S., Padilla, L., Jolly, P. E. (2017). Anemia in pregnancy in Western Jamaica. International Journal of Women's Health, 9, 431.
30. Wu, B. T., Innis, S. M., Mulder, K. A., Dyer, R. A., King, D. J. (2013). Low plasma vitamin B-12 is associated with a lower pregnancy-associated rise in plasma free choline in Canadian pregnant women and lower postnatal growth rates in their male infants. American Journal of Clinical Nutrition, 98(5), 1209-1217.
31. Yajnik, C. S., Deshpande, S. S., Panchanadikar, A. V., Naik, S. S., Deshpande, J. A., Coyaji, K. J., Refsum, H. (2005). Maternal total homocysteine concentration and neonatal size in India. Asia Pacific Journal of Clinical Nutrition, 14(2), 179-181.