Epidemiology Research Unit, Holdsworth Memorial Hospital, Mysore 570 021, South India.
J Nutr. 2010 May;140(5):1014-22. doi: 10.3945/jn.109.118075. Epub 2010 Mar 24.
Folate and vitamin B-12 are essential for normal brain development. Few studies have examined the relationship of maternal folate and vitamin B-12 status during pregnancy and offspring cognitive function. To test the hypothesis that lower maternal plasma folate and vitamin B-12 concentrations and higher plasma homocysteine concentrations during pregnancy are associated with poorer neurodevelopment, 536 children (aged 9-10 y) from the Mysore Parthenon birth cohort underwent cognitive function assessment during 2007-2008 using 3 core tests from the Kaufman Assessment Battery, and additional tests measuring learning, long-term storage/retrieval, attention and concentration, and visuo-spatial and verbal abilities. Maternal folate, vitamin B-12, and homocysteine concentrations were measured at 30 +/- 2 wk gestation. During pregnancy, 4% of mothers had low folate concentrations (<7 nmol/L), 42.5% had low vitamin B-12 concentrations (<150 pmol/L), and 3% had hyperhomocysteinemia (>10 micromol/L). The children's cognitive test scores increased by 0.1-0.2 SD per SD increase across the entire range of maternal folate concentrations (P < 0.001 for all), with no apparent associations at the deficiency level. The associations with learning, long-term storage/retrieval, visuo-spatial ability, attention, and concentration were independent of the parents' education, socioeconomic status, religion, and the child's sex, age, current size, and folate and vitamin B-12 concentrations. There were no consistent associations of maternal vitamin B-12 and homocysteine concentrations with childhood cognitive performance. In this Indian population, higher maternal folate, but not vitamin B-12, concentrations during pregnancy predicted better childhood cognitive ability. It also suggests that, in terms of neurodevelopment, the concentration used to define folate deficiency may be set too low.
叶酸和维生素 B-12 是大脑正常发育所必需的。很少有研究调查过妊娠期间母体叶酸和维生素 B-12 状态与后代认知功能的关系。为了验证“孕妇血液中叶酸和维生素 B-12 浓度降低以及同型半胱氨酸浓度升高与神经发育不良有关”的假说，我们对迈索尔帕特嫩出生队列中的 536 名儿童（9-10 岁）进行了研究，在 2007-2008 年期间，使用 Kaufman 评估测验中的 3 项核心测验对他们进行了认知功能评估，另外还测量了他们的学习能力、长期存储/检索能力、注意力和集中力以及视空间和语言能力。在妊娠 30±2 周时测量了母体叶酸、维生素 B-12 和同型半胱氨酸浓度。在妊娠期间，4%的母亲叶酸浓度较低（＜7nmol/L），42.5%的母亲维生素 B-12 浓度较低（＜150pmol/L），3%的母亲高同型半胱氨酸血症（＞10μmol/L）。在整个母体叶酸浓度范围内，儿童的认知测验分数每增加一个标准差就会增加 0.1-0.2 个标准差（所有 P＜0.001），在缺乏水平上没有明显的关联。学习能力、长期存储/检索能力、视空间能力、注意力和集中力与父母的教育程度、社会经济地位、宗教信仰以及孩子的性别、年龄、当前大小、叶酸和维生素 B-12 浓度无关。母体维生素 B-12 和同型半胱氨酸浓度与儿童认知表现之间没有一致的关联。在印度人群中，妊娠期间母体叶酸浓度较高，但维生素 B-12 浓度较低，与儿童认知能力较好有关。这也表明，就神经发育而言，用于定义叶酸缺乏的浓度可能设定得过低。
