印度南部孕妇及其婴儿的维生素 B 状况。
Vitamin B status in pregnant women and their infants in South India.
机构信息
Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA.
Division of Nutrition, St. John's Research Institute, Bangalore, India.
出版信息
Eur J Clin Nutr. 2017 Sep;71(9):1046-1053. doi: 10.1038/ejcn.2017.29. Epub 2017 Apr 12.
BACKGROUND/OBJECTIVES: Vitamin B deficiency during pregnancy has been associated with increased risk of adverse perinatal outcomes. However, few studies have investigated the burden and determinants of vitamin B status in young infants. This study was conducted to determine the associations between maternal and infant vitamin B status.
SUBJECTS/METHODS: Pregnant women participating in a vitamin B supplementation trial in Bangalore, India, were randomized to receive vitamin B (50 μg) or placebo supplementation daily during pregnancy through 6 weeks postpartum. All women received 60 mg of iron and 500 μg of folic acid daily during pregnancy, as per standard of care. This prospective analysis was conducted to determine the associations between maternal vitamin B biomarkers (that is, plasma vitamin B, methylmalonic acid (MMA) and tHcy) during each trimester with infant vitamin B status (n=77) at 6 weeks of age.
RESULTS
At baseline (⩽14 weeks of gestation), 51% of mothers were vitamin B deficient (vitamin B<150 pmol/l) and 43% had impaired vitamin B status (vitamin B<150 pmol/l and MMA>0.26 μmol/l); 44% of infants were vitamin B deficient at 6 weeks of age. After adjusting for vitamin B supplementation, higher vitamin B concentrations in each trimester were associated with increased infant vitamin B concentrations and lower risk of vitamin B deficiency in infants (P<0.05). After adjusting for vitamin B supplementation, infants born to women with vitamin B deficiency had a twofold greater risk of vitamin B deficiency (P<0.01). Higher maternal folate concentrations also predicted lower risk of vitamin B deficiency in infants (P<0.05). Impaired maternal vitamin B status, which combined both circulating and functional biomarkers, was the single best predictor of infant vitamin B status.
CONCLUSIONS
Impaired maternal vitamin B status throughout pregnancy predicted higher risk of vitamin B deficiency in infants, after adjusting for vitamin B supplementation. Future interventions are needed to improve vitamin B status periconceptionally, and to ensure optimal vitamin B status and health outcomes in pregnant women and their children.
背景/目的：孕妇维生素 B 缺乏与围产期不良结局风险增加有关。然而，很少有研究调查婴儿维生素 B 状况的负担和决定因素。本研究旨在确定母婴维生素 B 状况之间的关联。
受试者/方法：参与印度班加罗尔维生素 B 补充试验的孕妇被随机分配在妊娠期间每天接受维生素 B（50μg）或安慰剂补充，持续至产后 6 周。所有女性在妊娠期间每天接受 60mg 铁和 500μg 叶酸，这是标准护理。本前瞻性分析旨在确定每个孕期孕妇维生素 B 生物标志物（即血浆维生素 B、甲基丙二酸（MMA）和 tHcy）与 6 周龄婴儿维生素 B 状况（n=77）之间的关联。
结果
在基线（<14 周妊娠）时，51%的母亲维生素 B 缺乏（维生素 B<150pmol/l），43%的母亲维生素 B 状态受损（维生素 B<150pmol/l 和 MMA>0.26μmol/l）；44%的婴儿在 6 周龄时维生素 B 缺乏。在校正维生素 B 补充后，每个孕期维生素 B 浓度升高与婴儿维生素 B 浓度升高和婴儿维生素 B 缺乏风险降低相关（P<0.05）。在校正维生素 B 补充后，母亲维生素 B 缺乏的婴儿发生维生素 B 缺乏的风险增加两倍（P<0.01）。较高的母体叶酸浓度也预测婴儿发生维生素 B 缺乏的风险降低（P<0.05）。受损的母体维生素 B 状态，同时结合了循环和功能生物标志物，是婴儿维生素 B 状态的最佳预测因素。
结论
在校正维生素 B 补充后，整个孕期受损的母体维生素 B 状况预测婴儿发生维生素 B 缺乏的风险更高。需要未来的干预措施来改善围孕期的维生素 B 状况，并确保孕妇及其儿童的维生素 B 状况和健康结局最佳。
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