妊娠和哺乳期补充维生素 B-12 不会影响 6 岁儿童的神经生理结局。

Vitamin B-12 Supplementation during Pregnancy and Early Lactation Does Not Affect Neurophysiologic Outcomes in Children Aged 6 Years.

机构信息

Division of Mental Health and Neurosciences, St. John's Research Institute, Bengaluru, Karnataka, India.

Department of Biostatistics, St. John's Medical College, Bengaluru, Karnataka, India.

出版信息

J Nutr. 2020 Jul 1;150(7):1951-1957. doi: 10.1093/jn/nxaa123.

DOI:10.1093/jn/nxaa123

PMID:32470975

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7330478/

Abstract

BACKGROUND

Deficiency of vitamin B-12 is common in pregnant Indian women. Assessment of neurophysiological measures using event-related potentials (ERPs) may yield additional information on the effects of maternal B-12 supplementation on child brain function.

OBJECTIVES

The objective of the study was to evaluate the effects of vitamin B-12 supplementation (50 μg daily orally) during pregnancy on the childhood ERP measures of positive waveform ∼300 ms after stimulus (P300) and mismatch negativity.

METHODS

This study was a follow-up of children born to pregnant women who received oral vitamin B-12 supplements (n = 62) compared with children of pregnant women who received placebo (n = 70) from a randomized controlled trial. The mean ± SD child age was 72 ± 1 mo. We used the Enobio system to assess the ERP measures P300 and mismatch negativity.

RESULTS

There were no significant differences in the primary outcomes, amplitudes, and latencies of the P300 results and the mismatch negativity between children in the supplementation and placebo groups. We combined the intervention and placebo groups for secondary analyses. On multiple variable regression analysis after adjusting for treatment group, intrauterine growth restriction, and home environment, P300 amplitude in children was significantly higher in the lowest tertile of third-trimester maternal methylmalonic acid (MMA) concentrations (β = 3034.04; 95% CI: 923.24, 5144.83) compared with the highest MMA tertile (β = 1612.12; 95% CI: -258.86, 3483.10, P = 0.005).

CONCLUSIONS

While no significant effects of maternal vitamin B-12 supplementation on children's ERP measures were seen at 72 mo, elevated maternal MMA concentrations in the third trimester were negatively associated with P300 amplitude in children. It may be worthwhile to study the impact of maternal and infant vitamin B-12 supplementation on childhood brain structure and function in longer and larger trials. The parent trial was registered at clinicaltrials.gov as NCT00641862.

摘要

背景

维生素 B-12 缺乏在印度孕妇中很常见。使用事件相关电位 (ERP) 评估神经生理学测量结果可能会提供有关母体 B-12 补充对儿童大脑功能影响的更多信息。

目的

本研究旨在评估孕期补充维生素 B-12（每天口服 50μg）对儿童刺激后 300 毫秒正波（P300）和失匹配负波的儿童 ERP 测量值的影响。

方法

本研究是对接受口服维生素 B-12 补充剂（n=62）的孕妇所生孩子与接受安慰剂（n=70）的孕妇所生孩子进行的后续研究，这是一项随机对照试验。儿童的平均年龄 ± 标准差为 72±1 个月。我们使用 Enobio 系统评估 ERP 测量值 P300 和失匹配负波。

结果

补充组和安慰剂组儿童的主要结局、P300 结果和失匹配负波的振幅和潜伏期无显著差异。我们将干预组和安慰剂组合并进行二次分析。在校正治疗组、宫内生长受限和家庭环境后，多元变量回归分析显示，第三孕期母亲甲基丙二酸（MMA）浓度最低三分位的儿童 P300 振幅明显高于最高 MMA 三分位（β=3034.04；95%CI：923.24，5144.83）（β=1612.12；95%CI：-258.86，3483.10，P=0.005）。

结论

虽然在 72 个月时没有观察到母体维生素 B-12 补充对儿童 ERP 测量值的显著影响，但第三孕期母体 MMA 浓度升高与儿童 P300 振幅呈负相关。在更长和更大的试验中研究母体和婴儿维生素 B-12 补充对儿童大脑结构和功能的影响可能是值得的。该母试验在 clinicaltrials.gov 上注册为 NCT00641862。