Division of Child Neurology and Metabolic Medicine, Center for Child and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany.
Division of Child Neurology and Metabolic Medicine, Center for Child and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany.
J Pediatr. 2021 Aug;235:42-48. doi: 10.1016/j.jpeds.2021.02.009. Epub 2021 Feb 11.
OBJECTIVE: To evaluate the clinical outcomes at age 1.5 ± 0.5 years of infants with vitamin B deficiency identified by newborn screening (NBS). STUDY DESIGN: Prospective multicenter observational study on health outcomes of 31 infants with vitamin B deficiency identified by NBS. Neurodevelopment was assessed by the Denver Developmental Screening Test. RESULTS: In 285 862 newborns screened between 2016 and 2019, the estimated birth prevalence of vitamin B deficiency was 26 in 100 000 newborns, with high seasonal variations (lowest in summer: 8 in 100 000). Infants participating in the outcome study (N = 31) were supplemented with vitamin B for a median (range) of 5.9 (1.1-16.2) months. All achieved age-appropriate test results in Denver Developmental Screening Test at age 15 (11-23) months and did not present with symptoms characteristic for vitamin B deficiency. Most (81%, n = 25) mothers of affected newborns had a hitherto undiagnosed (functional) vitamin B deficiency, and, subsequently, received specific therapy. CONCLUSIONS: Neonatal vitamin B deficiency can be screened by NBS, preventing the manifestation of irreversible neurologic symptoms and the recurrence of vitamin B deficiency in future pregnancies through adequate treatment of affected newborns and their mothers. The high frequency of mothers with migrant background having a newborn with vitamin B deficiency highlights the need for improved prenatal care.
目的:评估通过新生儿筛查(NBS)发现的维生素 B 缺乏症婴儿在 1.5±0.5 岁时的临床结局。
研究设计:对通过 NBS 发现的 31 例维生素 B 缺乏症婴儿健康结局进行前瞻性多中心观察性研究。神经发育通过丹佛发育筛查测试进行评估。
结果:在 2016 年至 2019 年筛查的 285862 例新生儿中,维生素 B 缺乏症的估计出生患病率为每 10 万新生儿中有 26 例,且具有明显的季节性变化(夏季最低:每 10 万新生儿中有 8 例)。参加结局研究的婴儿(N=31)接受了中位数(范围)为 5.9(1.1-16.2)个月的维生素 B 补充治疗。所有婴儿在 15 个月(11-23 个月)时均在丹佛发育筛查测试中达到了年龄适当的测试结果,且没有出现维生素 B 缺乏症的典型症状。大多数(81%,n=25)受影响新生儿的母亲此前存在未被诊断出的(功能性)维生素 B 缺乏症,随后接受了针对性治疗。
结论:新生儿维生素 B 缺乏症可以通过 NBS 进行筛查,通过对受影响新生儿及其母亲进行充分治疗,防止不可逆的神经症状表现,并预防未来妊娠中维生素 B 缺乏症的复发。具有移民背景的母亲所生新生儿维生素 B 缺乏症的高频率突出表明需要改善产前保健。
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