Department of Pediatric Hematology /Oncology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, İstanbul, Türkiye.
Department of Biochemistry, University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Türkiye.
Turk J Pediatr. 2024 Oct 7;66(4):429-438. doi: 10.24953/turkjpediatr.2024.4545.
Vitamin B12, an indispensable micronutrient, is pivotal in numerous physiological processes, with particular significance during pregnancy and fetal development. The increasing adoption of vegetarian diets and the economic challenges associated with accessing animal-based food sources contribute to the prevalence of vitamin B12 deficiency. This study aims to examine the levels of vitamin B12 and homocysteine in pregnant women upon admission for delivery and to analyze corresponding cord blood samples from their newborn infants in a substantial sample within the Istanbul metropolitan area.
This cross-sectional multicenter study included women aged ≥16 years admitted for delivery and their newborns ≥34 weeks. The demographic data and the results of complete blood counts within the previous 24 hours before birth were recorded. Vitamin B12 and homocysteine levels were measured in maternal and cord blood samples. The study parameters were compared between the groups based on the mothers' and babies' homocysteine and vitamin B12 levels.
The study included 832 pregnant women and 832 neonates. Anemia affected 36% of pregnant women, with a higher frequency in mothers with vitamin B12 deficiency. Seventy-eight mothers and 48.9% of neonates showed Vitamin B12 levels below 200 pg/mL, while elevated homocysteine levels were observed in 30% of mothers and 26% of neonates. Maternal vitamin B12 deficiency was significantly correlated with cord blood B12 deficiency and elevated homocysteine. The median cord blood vitamin B12 level was inversely correlated with the number of previous pregnancies.
Vitamin B12 deficiency is extremely common in pregnant women before delivery, significantly correlating to cord blood homocysteine and vitamin B12 levels. However, homocysteine alone is not a reliable marker for maternal vitamin B12 status. Implementing strategies to detect vitamin B12 deficiency and supplying adequate vitamin B12 supplementation during pregnancy holds the potential to enhance maternal and neonatal health in Türkiye.
维生素 B12 是一种不可或缺的微量营养素，在许多生理过程中起着关键作用，在妊娠和胎儿发育期间尤为重要。素食饮食的日益普及以及获取动物源性食物资源的经济挑战导致了维生素 B12 缺乏症的流行。本研究旨在检查伊斯坦布尔大都市区内大量样本中孕妇入院分娩时的维生素 B12 和同型半胱氨酸水平，并分析其新生儿的脐血样本。
这是一项横断面多中心研究，纳入了年龄≥16 岁的入院分娩的妇女及其≥34 周的新生儿。记录了产妇的人口统计学数据和分娩前 24 小时内的全血细胞计数结果。测量了产妇和脐血样本中的维生素 B12 和同型半胱氨酸水平。根据母亲和婴儿的同型半胱氨酸和维生素 B12 水平，比较了组间的研究参数。
该研究纳入了 832 名孕妇和 832 名新生儿。贫血影响了 36%的孕妇，维生素 B12 缺乏的孕妇中更为常见。78 名母亲和 48.9%的新生儿维生素 B12 水平低于 200pg/mL，而 30%的母亲和 26%的新生儿同型半胱氨酸水平升高。母亲的维生素 B12 缺乏与脐血 B12 缺乏和同型半胱氨酸升高显著相关。脐血维生素 B12 中位数与既往妊娠次数呈负相关。
在分娩前，孕妇的维生素 B12 缺乏极为常见，与脐血同型半胱氨酸和维生素 B12 水平显著相关。然而，同型半胱氨酸本身并不是母亲维生素 B12 状况的可靠标志物。在土耳其，实施检测维生素 B12 缺乏症的策略并在妊娠期间提供充足的维生素 B12 补充剂，有可能改善母婴健康。
