An observational study to find association of serum vitamin B12 and folate level with neonatal weight at a tertiary care centre
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20212173Keywords:
Neonatal outcome, Vitamin B12, Folic acid, Birth weightAbstract
Background: In developing countries like India, low birth weight is a challenging and important public health problem as it has adverse effect on growth and development of children. Vitamin B12 and folate are micronutrients essential for normal foetal growth and development. Maternal folate and B12 concentrations have been positively associated with birth weight. The aim of this study was to evaluate maternal folate and vitamin B12 status in pregnant women in third trimester of pregnancy and to find their relation with foetal birth weight.
Methods: 171 pregnant women in their third trimester with live singleton pregnancy were included in the study. S. vitamin B12 and folate levels were measured and results were analysed.
Results: Mean maternal vitamin B12 level in mothers with LBW infants was significantly lower than that of mothers of ABW infants (143.23±91.79 vs 188.8±109.64 respectively p≤0.001) and mean maternal folate level in mothers with LBW infants was lower than that of mothers of ABW infants (8.46±8.94 vs 9.96±12.57 respectively p=0.054). There was a weak positive but statistically significant correlation between baby weight (kg) and S. vitamin B12 (rho=0.24, p=0.002) and S. folate (rho=0.17, p=0.029).
Conclusions: The present study confirms that maternal low vitamin B12 level and low S. folate levels are associated with low birth weight so during antenatal visit women should be screened for vitamin B12 and folate deficiency and vitamin supplementation should be continued throughout the pregnancy.
References
Ahmed A, Akhter M, Sharmin S, Ara S, Hoque M. Relationship of Maternal Folic Acid and Vitamin B12 with birth weight and body proportion of newborn. Bangladesh J online. 2012;18(1):7-11.
Black RE. Micronutrients in pregnancy. Br J Nutr. 2001;85(2):193-7.
Weerd S, Steegers TRP, Boo TM, Thomas CM, Steegers EA. Maternal periconceptional biochemical and hematological parameters, vitamin profiles and pregnancy outcome. Eur J Clin Nutr. 2003;57(9):1128-34.
Beck S, Wojdyla D, Say L, Betran AP, Merialdi M, Requejo JH, et al. The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity. Bull World Health Organ. 2010;88(1):31-8.
Relton CL, Pearce MS, Parker L. The influence of erythrocyte folate and serum vitamin B12 status on birth weight. Br J Nutr. 2005;93(5):593-9.
Stover PJ. Physiology of folate and vitamin B12 in health and disease. Nutr Rev. 2004;62:3-12.
Refsum H. Folate, vitamin B12 and homocysteine in relation to birth defects and pregnancy outcome. Br J Nutr. 2001;85:109.
Zhang SM, Willett WC, Selhub J, Hunter DJ, Giovannucci EL, Holmes MD, et al. Plasma folate, vitamin B6, vitamin B12, homocysteine, and risk of breast cancer. J Natl Cancer Inst. 2003;95:373-80.
Pagan K, Hou J, Goldenberg RL, Cliver SP, Tamura T. Midpregnancy serum homocysteine and B-vitamin concentrations and fetal growth. Nutr Res. 2002;22:1133-41.
Dijk AE, Eijsden M, Stronks K, Gemke RJ, Vrijkotte TG. Maternal depressive symptoms, serum folate status, and pregnancy outcome: results of the Amsterdam Born Children and their Development study. Am J Obstet Gynecol. 2010;203(6):563.
Parazzini F, Chiaffarino F, Ricci E, Improta L, Monni G. Homocysteine, red cell, and plasma folate concentrations and birth weight in Italian women: results from a prospective study. J Matern Fetal Neonatal Med. 2011;24:427-31.
Lindblad B, Zaman S, Malik A, Martin H, Ekstrom AM, Amu S, et al. Folate, vitamin B12, and homocysteine levels in South Asian women with growth-retarded fetuses. Acta Obstet Gynecol Scand. 2005;84:1055-61.
Muthayya S, Dwarkanath P, Mhaskar M, Mhaskar R, Thomas A, Duggan C, Fawzi WW, et al. The relationship of neonatal serum vitamin B12 status with birth weight. Asia Pac J Clin Nutr. 2006;15:538-43.
Youssry M, Radwan A, Gebreel M, Patel T. The Impact of Third Trimester Maternal Serum Vitamin B12 and Folate Status on Fetal Birth Weight. Is Maternal Serum Homocysteine a Predictor of Low Birth Weight Infants?. Open J Obstet Gynecol. 2017;7:1102-15.
Dwarkanath P, Barzilay JR, Thomas T, Thomas A, Bhat S, Kurpad AV. 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. Am J Clin Nutr. 2013;98:1450-8.
Kaymaz C, Demir A, Bige O, Cagliyan E, Cimrin D, Demir N. Analysis of perinatal outcome by combination of first trimester maternal plasma homocysteine with uterine artery Doppler velocimetry. Prenat Diagn. 2011;31(13):1246-50.
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(5):1232-51.
Cowan L, Horgan RP. Risk factors for small for gestational age infants. Best Pract Res Clin Obstet Gynaecol. 2009;23(6):779-93.
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(1):113-20.
Bhate VK, Joshi SM, Ladkat RS, Deshmukh US, Lubree HG, Katre PA, et al. Vitamin B12 and folate during pregnancy and offspring motor, mental and social development at 2 years of age. J Dev Orig Health Dis. 2012;3(2):123-30.
Baker PN, Wheeler SJ, Sanders TA, Thomas JE, Hutchinson CJ, Clarke K, et al. A prospective study of micronutrient status in adolescent pregnancy. Am J Clin Nutr. 2009;89(4):1114-24.
Mamabolo RL, Alberts M, Levitt NS. The effect of maternal glucose metabolism, iron, vitamin B12 and folate status on pregnancy outcomes. South Afr J Clin Nutr. 2006;19:120-30.
Takimoto H, Mito N, Umegaki K, Ishiwaki A, Kusama K, Abe S, Yamawaki M, et al. Relationship between dietary folate intakes, maternal plasma total homocysteine and B-vitamins during pregnancy and fetal growth in Japan. Eur J Nutr. 2007;46(5):300-6.
Dayaldasani A, Ruiz EJ, Rodriguez EM, Rueda I, Perez VV, Yahyaoui R. Serum vitamin B12 levels during the first trimester of pregnancy correlate with newborn screening markers of vitamin B12 deficiency. Int J Vitam Nutr Res. 2014;84(1):92-7.
Hay G, Clausen T, Whitelaw A, Trygg K, Johnston C, Henriksen T, et al. Maternal folate and cobalamin status predicts vitamin status in newborns and 6-month-old infants. J Nutr. 2010;140(3):557-64.
Yajnik CS, Deshpande SS, Jackson AA, Refsum H, Rao S, Fisher DJ, et al. Vitamin B12 and folate concentrations during pregnancy and insulin resistance in the offspring: the Pune Maternal Nutrition Study. Diabetologia. 2008;51(1):29-38.
Kumari G, Ramnujam S. Assessment of Maternal Folic Acid and Vitamin B12 Supplement with Fetus Growth. Asian J Biomed Pharma Sci. 2016;6:25-7.
Rogne T, Tielemans MJ, Chong MF, Yajnik CS, Krishnaveni GV, Poston L, et al. Associations of Maternal Vitamin B12 Concentration in Pregnancy With the Risks of Preterm Birth and Low Birth Weight: A Systematic Review and Meta-Analysis of Individual Participant Data. Am J Epidemiol. 2017;185(3):212-23.
Guerra SEM, Paiva AA, Rondo PH, Yamasaki K, Terzi CA, Almeida V. Relationship between total homocysteine and folate levels in pregnant women and their newborn babies according to maternal serum levels of vitamin B12. BJOG. 2002;109(7):784-91.
Christian P, Khatry SK, Katz J, Pradhan EK, Clerq SC, Shrestha SR, et al. Effects of alternative maternal micronutrient supplements on low birth weight in rural Nepal: double blind randomised community trial. BMJ. 2003;326(7389):571.
Ronnenberg AG, Venners SA, Xu X, Chen C, Wang L, Guang W, et al. Preconception B-vitamin and homocysteine status, conception, and early pregnancy loss. Am J Epidemiol. 2007;166(3):304-12.
