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For: Li S, Mi B, Qu P, Liu D, Lei F, Wang D, Zeng L, Kang Y, Shen Y, Pei L, Zhu Z, Yan H, Liu X, Dang S. Association of antenatal vitamin B complex supplementation with neonatal vitamin B₁₂ status: evidence from a cluster randomized controlled trial. Eur J Nutr 2021;60:1031-9. [PMID: 32577886 DOI: 10.1007/s00394-020-02309-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 06/15/2020] [Indexed: 10/24/2022]

For:	Li S, Mi B, Qu P, Liu D, Lei F, Wang D, Zeng L, Kang Y, Shen Y, Pei L, Zhu Z, Yan H, Liu X, Dang S. Association of antenatal vitamin B complex supplementation with neonatal vitamin B₁₂ status: evidence from a cluster randomized controlled trial. Eur J Nutr 2021;60:1031-9. [PMID: 32577886 DOI: 10.1007/s00394-020-02309-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 06/15/2020] [Indexed: 10/24/2022]

Number

Cited by Other Article(s)

Finkelstein JL, Fothergill A, Venkatramanan S, Layden AJ, Williams JL, Crider KS, Qi YP. Vitamin B12 supplementation during pregnancy for maternal and child health outcomes. Cochrane Database Syst Rev 2024;1:CD013823. [PMID: 38189492 PMCID: PMC10772977 DOI: 10.1002/14651858.cd013823.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]

Abstract

BACKGROUND

Vitamin B12 deficiency is a major public health problem worldwide, with the highest burden in elderly people, pregnant women, and young children. Due to its role in DNA synthesis and methylation, folate metabolism, and erythropoiesis, vitamin B12 supplementation during pregnancy may confer longer-term benefits to maternal and child health outcomes.

OBJECTIVES

To evaluate the benefits and harms of oral vitamin B12 supplementation during pregnancy on maternal and child health outcomes.

SEARCH METHODS

We searched the Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov, the World Health Organization International Clinical Trials Registry Platform (ICTRP) on 2 June 2023, and reference lists of retrieved studies.

SELECTION CRITERIA

Randomised controlled trials (RCTs), quasi-RCTs, or cluster-RCTs evaluating the effects of oral vitamin B12 supplementation compared to placebo or no vitamin B12 supplementation during pregnancy.

DATA COLLECTION AND ANALYSIS

We used standard Cochrane methods. Four review authors independently assessed trial eligibility. Two review authors independently extracted data from included studies and conducted checks for accuracy. Three review authors independently assessed the risk of bias of the included studies using the Cochrane RoB 1 tool. We used GRADE to evaluate the certainty of evidence for primary outcomes.

MAIN RESULTS

The review included five trials with 984 pregnant women. All trials were conducted in low- and middle-income countries, including India, Bangladesh, South Africa, and Croatia. At enrolment, 26% to 51% of pregnant women had vitamin B12 deficiency (less than 150 pmol/L), and the prevalence of anaemia (haemoglobin less than 11.0 g/dL) ranged from 30% to 46%. The dosage of vitamin B12 supplementation varied from 5 μg/day to 250 μg/day, with administration beginning at 8 to 28 weeks' gestation through to delivery or three months' postpartum, and the duration of supplementation ranged from 8 to 16 weeks to 32 to 38 weeks. Three trials, involving 609 pregnant women, contributed data for meta-analyses of the effects of vitamin B12 supplementation compared to placebo or no vitamin B12 supplementation. Maternal anaemia: there may be little to no difference for maternal anaemia by intervention group, but the evidence is very uncertain (70.9% versus 65.0%; risk ratio (RR) 1.08, 95% confidence interval (CI) 0.93 to 1.26; 2 trials, 284 women; very low-certainty evidence). Maternal vitamin B12 status: vitamin B12 supplementation during pregnancy may reduce the risk of maternal vitamin B12 deficiency compared to placebo or no vitamin B12 supplementation, but the evidence is very uncertain (25.9% versus 67.9%; RR 0.38, 95% CI 0.28 to 0.51; 2 trials, 272 women; very low-certainty evidence). Women who received vitamin B12 supplements during pregnancy may have higher total vitamin B12 concentrations compared to placebo or no vitamin B12 supplementation (mean difference (MD) 60.89 pmol/L, 95% CI 40.86 to 80.92; 3 trials, 412 women). However, there was substantial heterogeneity (I2 = 85%). Adverse pregnancy outcomes: the evidence is uncertain about the effect on adverse pregnancy outcomes, including preterm birth (RR 0.97, 95% CI 0.55 to 1.74; 2 trials, 340 women; low-certainty evidence), and low birthweight (RR 1.50, 95% CI 0.93 to 2.43; 2 trials, 344 women; low-certainty evidence). Two trials reported data on spontaneous abortion (or miscarriage); however, the trials did not report quantitative data for meta-analysis and there was no clear definition of spontaneous abortion in the study reports. No trials evaluated the effects of vitamin B12 supplementation during pregnancy on neural tube defects. Infant vitamin B12 status: children born to women who received vitamin B12 supplementation had higher total vitamin B12 concentrations compared to placebo or no vitamin B12 supplementation (MD 71.89 pmol/L, 95% CI 20.23 to 123.54; 2 trials, 144 children). Child cognitive outcomes: three ancillary analyses of one trial reported child cognitive outcomes; however, data were not reported in a format that could be included in quantitative meta-analyses. In one study, maternal vitamin B12 supplementation did not improve neurodevelopment status (e.g. cognitive, language (receptive and expressive), motor (fine and gross), social-emotional, or adaptive (conceptual, social, practical) domains) in children compared to placebo (9 months, Bayley Scales of Infant and Toddler Development Third Edition (BSID-III); 1 trial; low-certainty evidence) or neurophysiological outcomes (72 months, event-related potential measures; 1 trial; low-certainty evidence), though children born to women who received vitamin B12 supplementation had improved expressive language domain compared to placebo (30 months, BSID-III; 1 trial; low-certainty evidence).

AUTHORS' CONCLUSIONS

Oral vitamin B12 supplementation during pregnancy may reduce the risk of maternal vitamin B12 deficiency and may improve maternal vitamin B12 concentrations during pregnancy or postpartum compared to placebo or no vitamin B12 supplementation, but the evidence is very uncertain. The effects of vitamin B12 supplementation on other primary outcomes assessed in this review were not reported, or were not reported in a format for inclusion in quantitative analyses. Vitamin B12 supplementation during pregnancy may improve maternal and infant vitamin B12 status, but the potential impact on longer-term clinical and functional maternal and child health outcomes has not yet been established.

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Maternal Hemoglobin Concentrations and Birth Weight, Low Birth Weight (LBW), and Small for Gestational Age (SGA): Findings from a Prospective Study in Northwest China. Nutrients 2022;14:nu14040858. [PMID: 35215507 PMCID: PMC8879779 DOI: 10.3390/nu14040858] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/12/2022] [Accepted: 02/16/2022] [Indexed: 12/18/2022] Open

Li S, Liu D, Kang Y, Qu P, Mi B, Zhu Z, Han L, Zhao Y, Chen F, Pei L, Zeng L, Wang D, Yan H, Dang S. Associations of B Vitamin-Related Dietary Pattern during Pregnancy with Birth Outcomes: A Population-Based Study in Northwest China. Nutrients 2022;14:nu14030600. [PMID: 35276959 PMCID: PMC8838836 DOI: 10.3390/nu14030600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/26/2022] [Accepted: 01/27/2022] [Indexed: 02/04/2023] Open

Affiliation(s)

Shanshan Li School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian 271016, China;
Danmeng Liu Department of Epidemiology and Health Statistics, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China; (D.L.); (Y.K.); (B.M.); (Z.Z.); (Y.Z.); (F.C.); (L.P.); (L.Z.); (H.Y.)
Yijun Kang Department of Epidemiology and Health Statistics, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China; (D.L.); (Y.K.); (B.M.); (Z.Z.); (Y.Z.); (F.C.); (L.P.); (L.Z.); (H.Y.)
Pengfei Qu Translational Medicine Center, Northwest Women’s and Children’s Hospital, Xi’an 710061, China;
Baibing Mi Department of Epidemiology and Health Statistics, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China; (D.L.); (Y.K.); (B.M.); (Z.Z.); (Y.Z.); (F.C.); (L.P.); (L.Z.); (H.Y.)
Zhonghai Zhu Department of Epidemiology and Health Statistics, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China; (D.L.); (Y.K.); (B.M.); (Z.Z.); (Y.Z.); (F.C.); (L.P.); (L.Z.); (H.Y.)
Lixin Han Key Laboratory of Trace Elements and Endemic Diseases of National Health Commission, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China; Disease Control and Prevention Division, Shaanxi Provincial Health Commission, Xi’an 710000, China
Yaling Zhao Department of Epidemiology and Health Statistics, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China; (D.L.); (Y.K.); (B.M.); (Z.Z.); (Y.Z.); (F.C.); (L.P.); (L.Z.); (H.Y.)
Fangyao Chen Department of Epidemiology and Health Statistics, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China; (D.L.); (Y.K.); (B.M.); (Z.Z.); (Y.Z.); (F.C.); (L.P.); (L.Z.); (H.Y.)
Leilei Pei Department of Epidemiology and Health Statistics, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China; (D.L.); (Y.K.); (B.M.); (Z.Z.); (Y.Z.); (F.C.); (L.P.); (L.Z.); (H.Y.)
Lingxia Zeng Department of Epidemiology and Health Statistics, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China; (D.L.); (Y.K.); (B.M.); (Z.Z.); (Y.Z.); (F.C.); (L.P.); (L.Z.); (H.Y.)
Duolao Wang Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK;
Hong Yan Department of Epidemiology and Health Statistics, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China; (D.L.); (Y.K.); (B.M.); (Z.Z.); (Y.Z.); (F.C.); (L.P.); (L.Z.); (H.Y.) Nutrition and Food Safety Engineering Research Center of Shaanxi Province, Xi’an 710061, China
Shaonong Dang Department of Epidemiology and Health Statistics, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China; (D.L.); (Y.K.); (B.M.); (Z.Z.); (Y.Z.); (F.C.); (L.P.); (L.Z.); (H.Y.) Correspondence:

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