Koc Ahmet, Kocyigit Abdurrahim, Soran Mustafa, Demir Nihat, Sevinc Eylem, Erel Ozcan, Mil Zeki
Research Hospital, Dept. of Pediatric Hematology, Harran University Faculty of Medicine Research Hospital, 63 100 Sanliurfa, Turkey.
Eur J Nutr. 2006 Aug;45(5):291-7. doi: 10.1007/s00394-006-0598-7. Epub 2006 Apr 6.
Vitamin B12 deficiency in infancy may cause failure to thrive, severe neurological disorders and megaloblastic pancytopenia. It is well known that infants born with deficient vitamin B12 storage have increased the risk of vitamin B12 deficiency. Vitamin B12 deficiency is more prevalent in infancy in Sanliurfa province (at the southeast region of Turkey).
The aim of this study was to determine the frequencies of vitamin B12, folic acid and iron deficiencies in pregnants and their babies at birth and to what extend the mothers' deficiency becomes effective on babies' deficiencies.
The study groups were constituted by 180 pregnant women and their single and term babies. Venous blood samples of pregnants were obtained 1-3 h before delivery and babies' cord bloods were collected at birth. Vitamin B12 and folic acid levels were measured with electro chemiluminiscence method; serum iron and iron binding capacities were measured by colorimetric method and complete blood counts were performed by automatic blood counter.
Mean vitamin B12 levels in maternal and cord blood serum were 130 +/- 61.7 pg/ml and 207 +/- 141 pg/ml; mean folic acid levels were 8.91 +/- 6.46 ng/ml and 17.8 +/- 11.8 ng/ml; mean serum iron levels were 56.9 +/- 37.5 microg/dl and 147 +/- 43.2 microg/dl; and mean transferrin saturations were 11.8 +/- 8% and 65.6 +/- 24%, respectively. There were vitamin B12 deficiency (<160 pg/ml) in 72% of the mothers and 41% of the babies, and severe deficiency (<120 pg/ml) in 48% of the mothers and 23% of the babies. Folic acid deficiency was found in 12% of the mothers, but was not found in the babies. There were iron deficiency in 62% of the mothers and 1% of the babies. There were statistically significant correlation between maternal and cord blood serum vitamin B12 levels (r = 0.395, P < 0.001) and folic acid levels (r = 0.227, P = 0.017), while there were no correlation between maternal and cord blood iron levels and transferrin saturations.
The study results showed that vitamin B12 deficiency is prevalent in pregnants in this region and that 41% of infants have born with deficient vitamin B12 storages. Therefore, prophylactic use of vitamin B12 by pregnant women in Sanliurfa and other poor communities could have considerable benefits to prevent vitamin B12 deficiency and its complications in infants.
婴儿期维生素B12缺乏可能导致发育不良、严重神经障碍和巨幼细胞性全血细胞减少。众所周知，出生时维生素B12储存不足的婴儿患维生素B12缺乏症的风险增加。维生素B12缺乏在土耳其东南部的桑尼乌法省婴儿期更为普遍。
本研究的目的是确定孕妇及其出生时的婴儿维生素B12、叶酸和铁缺乏的频率，以及母亲的缺乏对婴儿缺乏的影响程度。
研究组由180名孕妇及其单胎足月婴儿组成。在分娩前1 - 3小时采集孕妇静脉血样本，出生时采集婴儿脐带血。采用电化学发光法测定维生素B12和叶酸水平；采用比色法测定血清铁和铁结合能力，采用自动血液计数器进行全血细胞计数。
母血和脐带血血清中维生素B12的平均水平分别为130±61.7 pg/ml和207±141 pg/ml；叶酸平均水平分别为8.91±6.46 ng/ml和17.8±11.8 ng/ml；血清铁平均水平分别为56.9±37.5 μg/dl和147±4
3.2 μg/dl；转铁蛋白饱和度平均分别为11.8±8%和65.6±24%。72%的母亲和41%的婴儿存在维生素B12缺乏（<160 pg/ml），48%的母亲和23%的婴儿存在严重缺乏（<120 pg/ml）。12%的母亲存在叶酸缺乏，但婴儿中未发现。62%的母亲和1%的婴儿存在缺铁。母血和脐带血血清维生素B12水平（r = 0.395，P < 0.001）和叶酸水平（r = 0.227，P = 0.017）之间存在统计学显著相关性，而母血和脐带血铁水平及转铁蛋白饱和度之间无相关性。
研究结果表明，该地区孕妇中维生素B12缺乏普遍存在，41%的婴儿出生时维生素B12储存不足。因此，在桑尼乌法及其他贫困社区的孕妇预防性使用维生素B12可能对预防婴儿维生素B12缺乏及其并发症有显著益处。
