在肯尼亚农村地区，以玉米为主食的妇女在孕期和哺乳期维生素B12摄入量较低，且母乳中维生素B12含量也较低。

Low vitamin B12 intake during pregnancy and lactation and low breastmilk vitamin 12 content in rural Kenyan women consuming predominantly maize diets.

作者信息

Neumann Charlotte G, Oace Susan M, Chaparro M Pia, Herman Dena, Drorbaugh Natalie, Bwibo Nimrod O

机构信息

Department of Community Health Sciences, UCLA Fielding School of Public Health, P.O. Box 951772, Los Angeles, CA 90095, USA.

出版信息

Food Nutr Bull. 2013 Jun;34(2):151-9. doi: 10.1177/156482651303400204.

DOI:10.1177/156482651303400204

PMID:23964388

Abstract

BACKGROUND

Vitamin B12 deficiency during pregnancy and lactation may negatively affect fetal growth, brain development, pregnancy outcome, and breastmilk vitamin B12 content.

OBJECTIVE

To examine associations between pregnant and lactating women's vitamin B12 intake and pregnancy outcomes, breastmilk vitamin B12 concentration, and growth and development of breastfed infants from birth to 6 months.

METHODS

One hundred thirty-eight Kenyan women were followed during pregnancy, with 98 followed through 6 months of lactation and providing 294 randomly collected breastmilk samples. Maternal hematologic analyses were performed for erythrocyte morphology, erythrocyte size, and serum vitamin B12 concentration. Women's and infants'food intake was assessed. Breastmilk vitamin B12 was measured by a competitive binding isotope dilution technique. Infant anthropometric data and the Brazelton Neonatal Behavioral Assessment Scale (BNBAS) were assessed within 3 days after birth. The Infant Bayley Motor Scale was assessed at 6 months. Statistical analyses included simple regression and correlation analyses in relation to vitamin B12 status and gestational age.

RESULTS

Intrauterine growth restriction and stillbirths were correlated with maternal macrocytic anemia and hypersegmented polymorphonuclear nuclei. Postpartum maternal vitamin B12 intake influenced breastmilk vitamin B12 levels 1 to 6 months postpartum. No associations were found between vitamin B12 intake during pregnancy or vitamin B12 levels in breastmilk and infant length, weight, or head circumference at birth or 6 months. Vitamin B12 intake during pregnancy was correlated with improved scores on infants' BNBAS reflex subscale (R = -0.19, p = .05) with adjustment for gestational age. Bayley Motor Scale results at 6 months were not significantly associated with breastmilk or supplemental feeding vitamin B12 content.

CONCLUSIONS

Vitamin B12 deficiency may adversely affect pregnancy outcome, infant reflexes at birth, and breastmilk vitamin B12 content.

摘要

背景

孕期和哺乳期维生素B12缺乏可能会对胎儿生长、大脑发育、妊娠结局以及母乳中维生素B12含量产生负面影响。

目的

研究孕妇和哺乳期妇女的维生素B12摄入量与妊娠结局、母乳中维生素B12浓度以及母乳喂养婴儿出生至6个月时生长发育之间的关联。

方法

对138名肯尼亚妇女进行孕期跟踪，其中98名妇女在哺乳期持续跟踪6个月，并提供了294份随机采集的母乳样本。对孕妇进行血液学分析，检测红细胞形态、红细胞大小和血清维生素B12浓度。评估妇女和婴儿的食物摄入量。采用竞争性结合同位素稀释技术测定母乳中维生素B12含量。在婴儿出生后3天内评估其人体测量数据和布雷泽尔顿新生儿行为评估量表（BNBAS）。在婴儿6个月时评估贝利婴儿运动量表。统计分析包括与维生素B12状态和孕周相关的简单回归和相关分析。

结果

宫内生长受限和死产与孕妇巨幼细胞贫血和多分叶多形核细胞有关。产后母亲维生素B12摄入量影响产后1至6个月母乳中维生素B12水平。未发现孕期维生素B12摄入量或母乳中维生素B12水平与婴儿出生时或6个月时的身长、体重或头围之间存在关联。孕期维生素B12摄入量与婴儿BNBAS反射子量表得分改善相关（R = -0.19，p = 0.05），校正孕周后。6个月时的贝利运动量表结果与母乳或补充喂养的维生素B12含量无显著关联。