Bjørke Monsen A L, Ueland P M, Vollset S E, Guttormsen A B, Markestad T, Solheim E, Refsum H
LOCUS for Homocysteine and Related Vitamins, University of Bergen, Bergen, Norway.
Pediatrics. 2001 Sep;108(3):624-30. doi: 10.1542/peds.108.3.624.
Cobalamin deficiency accompanied by bone marrow dysfunction and impaired central nervous system development has been reported in infants who were born to mothers with low cobalamin intake. We investigated the relation between cobalamin status in newborns and in their healthy mothers who consumed an omnivorous diet.
Serum cobalamin and the functional markers plasma methylmalonic acid (MMA) and total homocysteine (tHcy) were determined in 173 newborns and their mothers. Forty-five children and mothers were reinvestigated after 6 weeks.
At birth, median (interquartile range) serum cobalamin levels were 245 (175-323) pmol/L in the mothers and 314 (238-468) pmol/L in the newborns. In the neonates, serum cobalamin, but not folate, was inversely associated with MMA and tHcy. Among maternal factors, low serum cobalamin was the strongest predictor of impaired cobalamin function (defined as low cobalamin, high tHcy, or high MMA levels) in the newborns. After 6 weeks, the maternal cobalamin levels had increased (to 421 [271-502] pmol/L), whereas the newborn levels had declined (to 230 [158-287] pmol/L). In the same interval, the infants had a marked increase in plasma MMA (from 0.29 [0.24-0.38] to 0.81 [0.37-1.68] micromol/L). At 6 weeks, parity was a strong predictor of cobalamin status in the infant.
The cobalamin status in the neonatal period is strongly associated with maternal cobalamin status and parity. A reduction in serum cobalamin and an increase in metabolite levels are consistent with impaired cobalamin function in a significant portion of the infants who were born to healthy, nonvegetarian mothers.
据报道，母亲钴胺素摄入量低的婴儿会出现钴胺素缺乏，并伴有骨髓功能障碍和中枢神经系统发育受损。我们调查了食用杂食的健康母亲及其新生儿的钴胺素状态之间的关系。
测定了173名新生儿及其母亲的血清钴胺素以及功能性标志物血浆甲基丙二酸（MMA）和总同型半胱氨酸（tHcy）。45名儿童及其母亲在6周后再次接受检测。
出生时，母亲血清钴胺素水平中位数（四分位间距）为245（175 - 323）pmol/L，新生儿为314（238 - 468）pmol/L。在新生儿中，血清钴胺素而非叶酸与MMA和tHcy呈负相关。在母亲的各项因素中，低血清钴胺素是新生儿钴胺素功能受损（定义为钴胺素水平低、tHcy水平高或MMA水平高）的最强预测指标。6周后，母亲的钴胺素水平有所升高（至421 [271 - 502] pmol/L），而新生儿的水平有所下降（至230 [158 - 287] pmol/L）。在同一时期，婴儿血浆MMA显著升高（从0.29 [0.24 - 0.38] 微摩尔/升至0.81 [0.37 - 1.68] 微摩尔/升）。6周时，产次是婴儿钴胺素状态的一个强预测指标。
新生儿期的钴胺素状态与母亲的钴胺素状态和产次密切相关。血清钴胺素降低和代谢物水平升高表明，很大一部分由健康的非素食母亲所生的婴儿存在钴胺素功能受损的情况。
