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Santos-Calderón LA, Rojas-Gómez A, Ramos-Rodríguez C, Murphy MM. Indicators of Cobalamin Status During Pregnancy, Pregnancy Outcome and Long-Term Effects on Offspring Health. Food Nutr Bull 2024; 45:S10-S15. [PMID: 38987881 DOI: 10.1177/03795721241229502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2024]
Abstract
BACKGROUND Little attention has been given to prenatal cobalamin insufficiency in settings where dietary cobalamin intake is presumed adequate, such as populations with habitual intake of foods from animal sources. RESULTS However, low cobalamin status in women of fertile age has been reported in Europe, United States, and Canada. In India, where cobalamin deficiency is highly prevalent, it has been associated with an increased risk of miscarriage, intrauterine growth retardation, as well as insulin resistance and lower neurodevelopment scores in the offspring. Low cobalamin status in pregnancy has been associated with similar outcomes as those reported in the Indian studies although the evidence is scant and conflicting. CONCLUSIONS Consideration should be given to maternal cobalamin status in the context of prevention of adverse pregnancy outcomes as well as cobalamin insufficiency both in the mother and the offspring during lactation. Further attention is now justified with the increasing tendency toward plant-based diets. Reference intervals for cobalamin status during each trimester of pregnancy are needed and further investigation of the long-term conse-quences of low cobalamin status during pregnancy for health and development in the offspring is warranted.
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Affiliation(s)
- Luis Adolfo Santos-Calderón
- Unit of Preventive Medicine and Public Health, Faculty of Medicine and Health Sciences, Reus, IISPV, Universitat Rovira i Virgili, Spain
| | - Alejandra Rojas-Gómez
- Unit of Preventive Medicine and Public Health, Faculty of Medicine and Health Sciences, Reus, IISPV, Universitat Rovira i Virgili, Spain
| | - Carla Ramos-Rodríguez
- Unit of Preventive Medicine and Public Health, Faculty of Medicine and Health Sciences, Reus, IISPV, Universitat Rovira i Virgili, Spain
| | - Michelle M Murphy
- Unit of Preventive Medicine and Public Health, Faculty of Medicine and Health Sciences, Reus, IISPV, Universitat Rovira i Virgili, Spain
- CIBERObn (Instituto de Salud Carlos III), Spain
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2
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Jembere F, Dewey D. Prenatal Vitamin B12 and Children's Brain Development and Cognitive, Language and Motor Outcomes: A Scoping Review. CHILDREN (BASEL, SWITZERLAND) 2024; 11:558. [PMID: 38790553 PMCID: PMC11120302 DOI: 10.3390/children11050558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 05/01/2024] [Accepted: 05/03/2024] [Indexed: 05/26/2024]
Abstract
Adequate maternal nutrient intake of vitamin B12 is critical to fetal brain development and subsequent neurodevelopmental outcomes. We conducted a scoping review to map the current state of knowledge from human epidemiological studies on the associations between maternal vitamin B12 during pregnancy and children's brain, cognitive, language, and motor development to identify gaps in the literature and suggest directions for future research. PubMed and OVID MEDLINE were searched. Search terms were vitamin B12, prenatal or maternal, neurodevelopment or cognitive development or brain. Animal studies were excluded. In total, 148 publications were identified, of which 19 met our inclusion criteria: (1) maternal vitamin B12 assessed via a measure of status, dietary intake, supplementation, or deficiency; and (2) an outcome related to brain development or cognitive, language, or motor development in children less than 18 years of age was assessed. This scoping review suggests that evidence supporting a relationship between maternal vitamin B12 during pregnancy and children's neurodevelopmental outcomes is inconclusive. Further longitudinal research is needed to clarify the effects of maternal vitamin B12 supplementation, status, and intake on children's brain development and neurodevelopmental outcomes.
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Affiliation(s)
- Fasika Jembere
- Undergraduate Medical Education, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada;
| | - Deborah Dewey
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Owerko Centre, Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Hotchkiss Brain Institute and Mathison Centre for Mental Health and Research, University of Calgary, Calgary, AB T2N 4N1, Canada
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3
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Cruz‐Rodríguez J, Canals‐Sans J, Hernández‐Martínez C, Voltas‐Moreso N, Arija V. Prenatal vitamin B12 status and cognitive functioning in children at 4 years of age: The ECLIPSES Study. MATERNAL & CHILD NUTRITION 2024; 20:e13580. [PMID: 37938197 PMCID: PMC10750008 DOI: 10.1111/mcn.13580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/05/2023] [Accepted: 10/17/2023] [Indexed: 11/09/2023]
Abstract
Maternal vitamin B12 deficiency has been associated with disturbed cognitive functioning in offspring at different ages during childhood. However, this association has not been explored in pre-school-age children. The objective of this study was to examine the association between maternal vitamin B12 levels at the beginning and end of pregnancy and cognitive functioning in their children at 4 years of age. This longitudinal prospective study included a subsample of pregnant women and their children aged 4 years (n = 249) who participated in the ECLIPSES Study conducted in the province of Tarragona, Spain, from 2013 to 2017. Maternal vitamin B12 concentrations were determined in the first and third trimesters, and sociodemographic, nutritional and psychological data were collected. The children's cognitive functioning was assessed using the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-IV) and subtests of the Neuropsychological Assessment of Development (NEPSY-II). The multivariable models showed a significant relationship between vitamin B12 and the working memory index in the first trimester of the pregnancy but not in the third trimester. Children of mothers in the second vitamin B12 level tertile (314-413 pg/mL) (β = 6.468, 95% confidence interval [CI]: = 2.054, 10.882, p = 0.004) and third vitamin B12 level tertile (≥414 pg/mL) (β = 4.703, 95% CI: = 0.292, 9.114, p = 0.037) scored higher in the working memory index of the WPPSI-IV than the children of mothers with vitamin B12 levels in the first tertile (<314 pg/mL). Maintaining an adequate level of maternal vitamin B12 during early pregnancy contributes to improved performance in childhood working memory at 4 years of age.
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Affiliation(s)
- Josué Cruz‐Rodríguez
- Nutrition and Mental Health Research Group (NUTRISAM)Universitat Rovira i Virgili (URV)TarragonaSpain
| | - Josefa Canals‐Sans
- Nutrition and Mental Health Research Group (NUTRISAM)Universitat Rovira i Virgili (URV)TarragonaSpain
- Institut d'Investigació Sanitària Pere Virgili (IISPV)TarragonaSpain
- Centre de Recerca en Avaluació i Mesura de la Conducta (CRAMC), Department of PsychologyUniversitat Rovira i VirgiliTarragonaSpain
| | - Carmen Hernández‐Martínez
- Nutrition and Mental Health Research Group (NUTRISAM)Universitat Rovira i Virgili (URV)TarragonaSpain
- Institut d'Investigació Sanitària Pere Virgili (IISPV)TarragonaSpain
- Centre de Recerca en Avaluació i Mesura de la Conducta (CRAMC), Department of PsychologyUniversitat Rovira i VirgiliTarragonaSpain
| | - Núria Voltas‐Moreso
- Nutrition and Mental Health Research Group (NUTRISAM)Universitat Rovira i Virgili (URV)TarragonaSpain
- Institut d'Investigació Sanitària Pere Virgili (IISPV)TarragonaSpain
- Centre de Recerca en Avaluació i Mesura de la Conducta (CRAMC), Department of PsychologyUniversitat Rovira i VirgiliTarragonaSpain
| | - Victoria Arija
- Nutrition and Mental Health Research Group (NUTRISAM)Universitat Rovira i Virgili (URV)TarragonaSpain
- Institut d'Investigació Sanitària Pere Virgili (IISPV)TarragonaSpain
- Institut d'Investigació en Atenció Primària IDIAP Jordi GolInstitut Català de la Salut (ICS)BarcelonaSpain
- Collaborative Research Group on Lifestyles, Nutrition and Smoking (CENIT)IDIAP Jordi GolReusSpain
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Godfrey KM, Titcombe P, El-Heis S, Albert BB, Tham EH, Barton SJ, Kenealy T, Chong MFF, Nield H, Chong YS, Chan SY, Cutfield WS. Maternal B-vitamin and vitamin D status before, during, and after pregnancy and the influence of supplementation preconception and during pregnancy: Prespecified secondary analysis of the NiPPeR double-blind randomized controlled trial. PLoS Med 2023; 20:e1004260. [PMID: 38051700 PMCID: PMC10697591 DOI: 10.1371/journal.pmed.1004260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 11/01/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Maternal vitamin status preconception and during pregnancy has important consequences for pregnancy outcome and offspring development. Changes in vitamin status from preconception through early and late pregnancy and postpartum have been inferred from cross-sectional data, but longitudinal data on vitamin status from preconception throughout pregnancy and postdelivery are sparse. As such, the influence of vitamin supplementation on vitamin status during pregnancy remains uncertain. This study presents one prespecified outcome from the randomized controlled NiPPeR trial, aiming to identify longitudinal patterns of maternal vitamin status from preconception, through early and late pregnancy, to 6 months postdelivery, and determine the influence of vitamin supplementation. METHODS AND FINDINGS In the NiPPeR trial, 1,729 women (from the United Kingdom, Singapore, and New Zealand) aged 18 to 38 years and planning conception were randomized to receive a standard vitamin supplement (control; n = 859) or an enhanced vitamin supplement (intervention; n = 870) starting in preconception and continued throughout pregnancy, with blinding of participants and research staff. Supplement components common to both treatment groups included folic acid, β-carotene, iron, calcium, and iodine; components additionally included in the intervention group were riboflavin, vitamins B6, B12, and D (in amounts available in over-the-counter supplements), myo-inositol, probiotics, and zinc. The primary outcome of the study was glucose tolerance at 28 weeks' gestation, measured by oral glucose tolerance test. The secondary outcome reported in this study was the reduction in maternal micronutrient insufficiency in riboflavin, vitamin B6, vitamin B12, and vitamin D, before and during pregnancy. We measured maternal plasma concentrations of B-vitamins, vitamin D, and markers of insufficiency/deficiency (homocysteine, hydroxykynurenine-ratio, methylmalonic acid) at recruitment, 1 month after commencing intervention preconception, in early pregnancy (7 to 11 weeks' gestation) and late pregnancy (around 28 weeks' gestation), and postdelivery (6 months after supplement discontinuation). We derived standard deviation scores (SDS) to characterize longitudinal changes among participants in the control group and measured differences between the 2 groups. At recruitment, the proportion of patients with marginal or low plasma status was 29.2% for folate (<13.6 nmol/L), 7.5% and 82.0% for riboflavin (<5 nmol/L and ≤26.5 nmol/L, respectively), 9.1% for vitamin B12 (<221 pmol/L), and 48.7% for vitamin D (<50 nmol/L); these proportions were balanced between the groups. Over 90% of all participants had low or marginal status for one or more of these vitamins at recruitment. Among participants in the control group, plasma concentrations of riboflavin declined through early and late pregnancy, whereas concentrations of 25-hydroxyvitamin D were unchanged in early pregnancy, and concentrations of vitamin B6 and B12 declined throughout pregnancy, becoming >1 SDS lower than baseline by 28 weeks gestation. In the control group, 54.2% of participants developed low late-pregnancy vitamin B6 concentrations (pyridoxal 5-phosphate <20 nmol/L). After 1 month of supplementation, plasma concentrations of supplement components were substantially higher among participants in the intervention group than those in the control group: riboflavin by 0.77 SDS (95% CI 0.68 to 0.87, p < 0.0001), vitamin B6 by 1.07 SDS (0.99 to 1.14, p < 0.0001), vitamin B12 by 0.55 SDS (0.46 to 0.64, p < 0.0001), and vitamin D by 0.51 SDS (0.43 to 0.60, p < 0.0001), with higher levels in the intervention group maintained during pregnancy. Markers of vitamin insufficiency/deficiency were reduced in the intervention group, and the proportion of participants with vitamin D insufficiency (<50 nmol/L) during late pregnancy was lower in the intervention group (35.1% versus 8.5%; p < 0.0001). Plasma vitamin B12 remained higher in the intervention group than in the control group 6 months postdelivery (by 0.30 SDS (0.14, 0.46), p = 0.0003). The main limitation is that generalizability to the global population is limited by the high-resource settings and the lack of African and Amerindian women in particular. CONCLUSIONS Over 90% of the trial participants had marginal or low concentrations of one or more of folate, riboflavin, vitamin B12, or vitamin D during preconception, and many developed markers of vitamin B6 deficiency in late pregnancy. Preconception/pregnancy supplementation in amounts available in over-the-counter supplements substantially reduces the prevalence of vitamin deficiency and depletion markers before and during pregnancy, with higher maternal plasma vitamin B12 maintained during the recommended lactational period. TRIAL REGISTRATION ClinicalTrials.gov NCT02509988; U1111-1171-8056.
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Affiliation(s)
- Keith M. Godfrey
- MRC Lifecourse Epidemiology Centre, University of Southampton, University Hospital Southampton, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton, NHS Foundation Trust, Southampton, United Kingdom
| | - Philip Titcombe
- MRC Lifecourse Epidemiology Centre, University of Southampton, University Hospital Southampton, Southampton, United Kingdom
| | - Sarah El-Heis
- MRC Lifecourse Epidemiology Centre, University of Southampton, University Hospital Southampton, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton, NHS Foundation Trust, Southampton, United Kingdom
| | | | - Elizabeth Huiwen Tham
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Sheila J. Barton
- MRC Lifecourse Epidemiology Centre, University of Southampton, University Hospital Southampton, Southampton, United Kingdom
| | - Timothy Kenealy
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Mary Foong-Fong Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Heidi Nield
- MRC Lifecourse Epidemiology Centre, University of Southampton, University Hospital Southampton, Southampton, United Kingdom
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore
| | - Shiao-Yng Chan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore
| | - Wayne S. Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand
- A Better Start, New Zealand National Science Challenge, Auckland, New Zealand
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Wirthensohn M, Wehrli S, Ljungblad UW, Huemer M. Biochemical, Nutritional, and Clinical Parameters of Vitamin B12 Deficiency in Infants: A Systematic Review and Analysis of 292 Cases Published between 1962 and 2022. Nutrients 2023; 15:4960. [PMID: 38068819 PMCID: PMC10708449 DOI: 10.3390/nu15234960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
Pooled data from published reports on infants with clinically diagnosed vitamin B12 (B12) deficiency were analyzed with the purpose of describing the presentation, diagnostic approaches, and risk factors for the condition to inform prevention strategies. An electronic (PubMed database) and manual literature search following the PRISMA approach was conducted (preregistration with the Open Science Framework, accessed on 15 February 2023). Data were described and analyzed using correlation analyses, Chi-square tests, ANOVAs, and regression analyses, and 102 publications (292 cases) were analyzed. The mean age at first symptoms (anemia, various neurological symptoms) was four months; the mean time to diagnosis was 2.6 months. Maternal B12 at diagnosis, exclusive breastfeeding, and a maternal diet low in B12 predicted infant B12, methylmalonic acid, and total homocysteine. Infant B12 deficiency is still not easily diagnosed. Methylmalonic acid and total homocysteine are useful diagnostic parameters in addition to B12 levels. Since maternal B12 status predicts infant B12 status, it would probably be advantageous to target women in early pregnancy or even preconceptionally to prevent infant B12 deficiency, rather than to rely on newborn screening that often does not reliably identify high-risk children.
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Affiliation(s)
- Miriam Wirthensohn
- Department of Pediatrics, Landeskrankenhaus Bregenz, 6900 Bregenz, Austria
| | - Susanne Wehrli
- Department of Psychosomatics and Psychiatry, University Children’s Hospital, University of Zurich, 8032 Zurich, Switzerland
- Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, 8050 Zurich, Switzerland
- Children’s Research Centre, University Children’s Hospital Zurich, University of Zurich, 8032 Zurich, Switzerland
- University Research Priority Program “ITINERARE—Innovative Therapies in Rare Diseases”, University of Zurich, 8032 Zurich, Switzerland
| | - Ulf Wike Ljungblad
- Department of Pediatrics, Vestfold Hospital Trust, NO-3168 Tønsberg, Norway
| | - Martina Huemer
- Department of Pediatrics, Landeskrankenhaus Bregenz, 6900 Bregenz, Austria
- Division of Metabolism and Children’s Research Center, University Children’s Hospital Zurich, University of Zurich, 8032 Zurich, Switzerland
- Vorarlberg University of Applied Sciences, Competence Area Healthcare and Nursing, 6850 Dornbirn, Austria
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Graham AS, Ben-Azu B, Tremblay MÈ, Torre P, Senekal M, Laughton B, van der Kouwe A, Jankiewicz M, Kaba M, Holmes MJ. A review of the auditory-gut-brain axis. Front Neurosci 2023; 17:1183694. [PMID: 37600010 PMCID: PMC10435389 DOI: 10.3389/fnins.2023.1183694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 07/17/2023] [Indexed: 08/22/2023] Open
Abstract
Hearing loss places a substantial burden on medical resources across the world and impacts quality of life for those affected. Further, it can occur peripherally and/or centrally. With many possible causes of hearing loss, there is scope for investigating the underlying mechanisms involved. Various signaling pathways connecting gut microbes and the brain (the gut-brain axis) have been identified and well established in a variety of diseases and disorders. However, the role of these pathways in providing links to other parts of the body has not been explored in much depth. Therefore, the aim of this review is to explore potential underlying mechanisms that connect the auditory system to the gut-brain axis. Using select keywords in PubMed, and additional hand-searching in google scholar, relevant studies were identified. In this review we summarize the key players in the auditory-gut-brain axis under four subheadings: anatomical, extracellular, immune and dietary. Firstly, we identify important anatomical structures in the auditory-gut-brain axis, particularly highlighting a direct connection provided by the vagus nerve. Leading on from this we discuss several extracellular signaling pathways which might connect the ear, gut and brain. A link is established between inflammatory responses in the ear and gut microbiome-altering interventions, highlighting a contribution of the immune system. Finally, we discuss the contribution of diet to the auditory-gut-brain axis. Based on the reviewed literature, we propose numerous possible key players connecting the auditory system to the gut-brain axis. In the future, a more thorough investigation of these key players in animal models and human research may provide insight and assist in developing effective interventions for treating hearing loss.
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Affiliation(s)
- Amy S. Graham
- Imaging Sciences, Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- Department of Human Biology, Division of Biomedical Engineering, University of Cape Town, Cape Town, South Africa
| | - Benneth Ben-Azu
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
- Department of Pharmacology, Faculty of Basic Medical Sciences, College of Health Sciences, Delta State University, Abraka, Delta State, Nigeria
| | - Marie-Ève Tremblay
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
- Département de Médecine Moléculaire, Université Laval, Québec City, QC, Canada
- Axe Neurosciences, Centre de Recherche du CHU de Québec, Université Laval, Quebec City, QC, Canada
- Neurology and Neurosurgery Department, McGill University, Montreal, QC, Canada
- Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, BC, Canada
- Centre for Advanced Materials and Related Technology (CAMTEC), University of Victoria, Victoria, BC, Canada
- Institute for Aging and Lifelong Health, University of Victoria, Victoria, BC, Canada
| | - Peter Torre
- School of Speech, Language, and Hearing Sciences, San Diego State University, San Diego, CA, United States
| | - Marjanne Senekal
- Department of Human Biology, Division of Physiological Sciences, University of Cape Town, Cape Town, South Africa
| | - Barbara Laughton
- Family Clinical Research Unit, Department of Pediatrics and Child Health, Stellenbosch University, Cape Town, South Africa
| | - Andre van der Kouwe
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States
- Department of Radiology, Harvard Medical School, Boston, MA, United States
| | - Marcin Jankiewicz
- Imaging Sciences, Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- Department of Human Biology, Division of Biomedical Engineering, University of Cape Town, Cape Town, South Africa
| | - Mamadou Kaba
- Department of Pathology, Division of Medical Microbiology, University of Cape Town, Cape Town, South Africa
| | - Martha J. Holmes
- Imaging Sciences, Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- Department of Human Biology, Division of Biomedical Engineering, University of Cape Town, Cape Town, South Africa
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
- ImageTech, Simon Fraser University, Surrey, BC, Canada
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7
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Chan SY, Barton SJ, Loy SL, Chang HF, Titcombe P, Wong JT, Ebreo M, Ong J, Tan KM, Nield H, El-Heis S, Kenealy T, Chong YS, Baker PN, Cutfield WS, Godfrey KM. Time-to-conception and clinical pregnancy rate with a myo-inositol, probiotics, and micronutrient supplement: secondary outcomes of the NiPPeR randomized trial. Fertil Steril 2023; 119:1031-1042. [PMID: 36754158 DOI: 10.1016/j.fertnstert.2023.01.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 01/11/2023] [Accepted: 01/30/2023] [Indexed: 02/09/2023]
Abstract
OBJECTIVE To determine whether a combined myo-inositol, probiotics and micronutrient nutritional supplement impacts time-to-natural-conception and clinical pregnancy rates. DESIGN Secondary outcomes of a double-blind randomized controlled trial. SETTING Community recruitment. PATIENTS Women aged 18 to 38 years planning to conceive in the United Kingdom, Singapore, and New Zealand, excluding those with diabetes mellitus or receiving fertility treatment. INTERVENTION A standard (control) supplement (folic acid, iron, calcium, iodine, β-carotene), compared with an intervention additionally containing myo-inositol, probiotics, and other micronutrients (vitamins B2, B6, B12, D, zinc). MAIN OUTCOME MEASURES Number of days between randomization and estimated date of natural conception of a clinical pregnancy, as well as cumulative pregnancy rates at 3, 6, and 12 months. RESULTS Of 1729 women randomized, 1437 (83%; intervention, n=736; control, n=701) provided data. Kaplan-Meier curves of conception were similar between intervention and control groups; the time at which 20% achieved natural conception was 90.5 days (95% confidence interval: 80.7, 103.5) in the intervention group compared with 92.0 days (76.0, 105.1) in the control group. Cox's proportional hazard ratios (HRs) comparing intervention against control for cumulative achievement of pregnancy (adjusted for site, ethnicity, age, body mass index, and gravidity) were similar at 3, 6, and 12 months. Among both study groups combined, overall time-to-conception lengthened with higher preconception body mass index, and was longer in non-White than in White women. Among women who were overweight the intervention shortened time-to-conception compared with control regardless of ethnicity (12-month HR=1.47 [1.07, 2.02], P=.016; 20% conceived by 84.5 vs. 117.0 days) and improved it to that comparable to nonoverweight/nonobese women (20% conceived by 82.1 days). In contrast, among women with obesity, time-to-conception was lengthened with intervention compared with control (12-month HR=0.69 [0.47, 1.00]; P=.053; 20% conceived by 132.7 vs. 108.5 days); an effect predominantly observed in non-White women with obesity. CONCLUSIONS Time-to-natural-conception and clinical pregnancy rates within a year were overall similar in women receiving the intervention supplement compared with control. Overweight women had a longer time-to-conception but there was suggestion that the supplement may shorten their time-to-conception to that comparable to the nonoverweight/nonobese women. Further studies are required to confirm this. CLINICAL TRIAL REGISTRATION NUMBER clinicaltrials.gov (NCT02509988).
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Affiliation(s)
- Shiao-Yng Chan
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore; Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A∗STAR), Singapore, Singapore.
| | - Sheila J Barton
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
| | - See Ling Loy
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A∗STAR), Singapore, Singapore; Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore, Singapore; Duke-NUS Medical School, Singapore, Singapore
| | - Hsin Fang Chang
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Philip Titcombe
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
| | - Jui-Tsung Wong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A∗STAR), Singapore, Singapore
| | - Marilou Ebreo
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Judith Ong
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Karen Ml Tan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A∗STAR), Singapore, Singapore
| | - Heidi Nield
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
| | - Sarah El-Heis
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
| | - Timothy Kenealy
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Yap-Seng Chong
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore; Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A∗STAR), Singapore, Singapore
| | - Philip N Baker
- College of Life Sciences, University of Leicester, Leicester, United Kingdom
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Keith M Godfrey
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom; National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton, Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom
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8
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Jaisamrarn U, Esteban-Habana MA, Padolina CS, Decena DCD, Dee MT, Damodaran P, Bhaskaran V, Garg V, Dorado E, Hu H. Vitamins and minerals, education, and self-care need during preconception to 1000 days of life in Southeast Asia: An expert panel opinion. SAGE Open Med 2023; 11:20503121231173377. [PMID: 37223672 PMCID: PMC10201185 DOI: 10.1177/20503121231173377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 04/14/2023] [Indexed: 05/25/2023] Open
Abstract
Addressing maternal malnutrition and its drivers is paramount in Southeast Asia. This article summarizes the key clinical learnings and evidence-based opinions from the experts to understand the need for vitamins and minerals supplementation, education, and self-care from preconception to the first 1000 days of life, which warranted further attention since COVID-19 pandemic. Evidence describing the importance of vitamins and minerals during preconception, pregnancy, and lactation stages was identified using literature databases. A pre-meeting survey was conducted to determine the current practices and challenges in Southeast Asia. Based on the literature review and clinical experience, experts defined the topics, and an online meeting was held on 13th July 2021. During the meeting, nine experts from Southeast Asia provided evidence-based opinion on the vitamins and minerals supplementation, education, and self-care need during preconception, pregnancy, and lactation stages. The expert opinions underpin maternal malnutrition as a prevalent issue and discuss appropriate interventions and prevention strategies for women in Southeast Asia. The recent pandemic further impacted nutrition status, pregnancy, and neonatal health outcomes. The expert panel emphasized a need to improve existing inadequacies in education, self-care, and social support, and discussed the role of policymakers in addressing the barriers to dietary changes. As inadequacies in regular vitamins and minerals supplementation, education, and self-care for women of reproductive age implicate maternal and child health outcomes, there is an urgent need for addressing malnutrition concerns in this population. Thus, a strong partnership between policymakers, healthcare professionals, and other relevant sectors is required.
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Affiliation(s)
- Unnop Jaisamrarn
- Faculty of Medicine, Chulalongkorn
University, Bangkok, Thailand
| | | | - Christia S Padolina
- University of the East Ramon Magsaysay
Memorial Medical Center, Quezon City, Philippines
| | | | - Marlyn T Dee
- UST Faculty of Medicine and Surgery,
Manila, Philippines
| | - Premitha Damodaran
- Pantai Hospital Kuala Lumpur, Wilayah
Persekutuan Kuala Lumpur, Malaysia
| | | | - Vandana Garg
- Haleon (formerly GSK Consumer
Healthcare), Singapore, Singapore
| | - Egbert Dorado
- Haleon (formerly GSK Consumer
Healthcare), Singapore, Singapore
| | - Henglong Hu
- Haleon (formerly GSK Consumer
Healthcare), Singapore, Singapore
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9
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Sourander A, Silwal S, Surcel HM, Hinkka-Yli-Salomäki S, Upadhyaya S, McKeague IW, Cheslack-Postava K, Brown AS. Maternal Serum Vitamin B12 during Pregnancy and Offspring Autism Spectrum Disorder. Nutrients 2023; 15:nu15082009. [PMID: 37111227 PMCID: PMC10146734 DOI: 10.3390/nu15082009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/17/2023] [Accepted: 04/19/2023] [Indexed: 04/29/2023] Open
Abstract
This study examined the association between maternal serum vitamin B12 levels during early pregnancy and offspring autism spectrum disorders (ASD) and subtypes. Based on a Finnish national birth cohort, case offspring (n = 1558) born in 1987-2007 and diagnosed with ASD by 2015 were matched with one control on date of birth, sex and place of birth. Maternal vitamin B12 levels were measured during first and early second trimesters of pregnancy. High maternal vitamin B12 levels (≥81th percentile) was associated with increased risk for offspring childhood autism, adjusted odds ratio, 1.59, 95% confidence interval 1.06-2.41 (p = 0.026). No significant associations were observed between maternal vitamin B12 levels and offspring Asperger's or pervasive developmental disorder/NOS.
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Affiliation(s)
- Andre Sourander
- Research Centre for Child Psychiatry, INVEST Flagship, University of Turku, 20014 Turku, Finland
- Department of Child Psychiatry, Turku University Hospital, 20521 Turku, Finland
| | - Sanju Silwal
- Research Centre for Child Psychiatry, INVEST Flagship, University of Turku, 20014 Turku, Finland
| | - Heljä-Marja Surcel
- Faculty of Medicine, University of Oulu, 90014 Oulu, Finland
- Biobank Borealis of Northern Finland, Oulu University Hospital, 90014 Oulu, Finland
| | | | - Subina Upadhyaya
- Research Centre for Child Psychiatry, INVEST Flagship, University of Turku, 20014 Turku, Finland
| | - Ian W McKeague
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY 10032, USA
| | - Keely Cheslack-Postava
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Alan S Brown
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY 10032, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY 10032, USA
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10
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Cruz-Rodríguez J, Díaz-López A, Canals-Sans J, Arija V. Maternal Vitamin B12 Status during Pregnancy and Early Infant Neurodevelopment: The ECLIPSES Study. Nutrients 2023; 15:nu15061529. [PMID: 36986259 PMCID: PMC10051123 DOI: 10.3390/nu15061529] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/14/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023] Open
Abstract
In this prospective cohort study of 434 mother-infant pairs from the ECLIPSES study, we examine the association between maternal vitamin B12 status at the beginning and end of pregnancy and the neurodevelopmental outcomes of infants 40 days after birth in a pregnant population from a Mediterranean region of northern Spain. Maternal vitamin B12 concentrations were determined in the first and third trimesters, and sociodemographic, nutritional, and psychological data were collected. At 40 days postpartum, the Bayley Scales of Infant Development-III (BSID-III, cognitive, language, and motor skills) were administered to the infants and several obstetrical data were recorded. In the multivariable models, medium maternal first-trimester vitamin B12 levels (312 to 408 pg/mL, tertile 2) were associated with better neonatal performance in the motor, gross motor, language, and cognitive skills with respect to tertile 1 (<312 pg/mL). The probability of obtaining a neonatal motor, gross motor, and receptive language score >75th percentile was significantly higher also in the tertile 2 group. In summary, good maternal vitamin B12 status in the early stage of pregnancy appears to be associated with better infant motor, language, and cognitive performance at 40 days postpartum.
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Affiliation(s)
- Josué Cruz-Rodríguez
- Nutrition and Mental Health Research Group (NUTRISAM), Universitat Rovira i Virgili (URV), 43201 Tarragona, Spain
| | - Andrés Díaz-López
- Nutrition and Mental Health Research Group (NUTRISAM), Universitat Rovira i Virgili (URV), 43201 Tarragona, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), 43005 Tarragona, Spain
| | - Josefa Canals-Sans
- Nutrition and Mental Health Research Group (NUTRISAM), Universitat Rovira i Virgili (URV), 43201 Tarragona, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), 43005 Tarragona, Spain
- Centre de Recerca en Avaluació i Mesura de la Conducta (CRAMC), Department of Psychology, Universitat Rovira i Virgili, 43007 Tarragona, Spain
| | - Victoria Arija
- Nutrition and Mental Health Research Group (NUTRISAM), Universitat Rovira i Virgili (URV), 43201 Tarragona, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), 43005 Tarragona, Spain
- Institut d'Investigació en Atenció Primària IDIAP Jordi Gol, Institut Català de la Salut (ICS), 08007 Barcelona, Spain
- Collaborative Research Group on Lifestyles, Nutrition and Smoking (CENIT), IDIAP Jordi Gol, 43202 Reus, Spain
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11
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Miceli E, Di Stefano M, Lenti MV, Pitotti L, Corazza GR, Di Sabatino A. Pregnancy-related complications in autoimmune atrophic gastritis: A monocentric experience. Dig Liver Dis 2023; 55:146-148. [PMID: 36289025 DOI: 10.1016/j.dld.2022.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/31/2022] [Accepted: 10/05/2022] [Indexed: 12/31/2022]
Affiliation(s)
- Emanuela Miceli
- Department of Internal Medicine, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Michele Di Stefano
- Department of Internal Medicine, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Marco Vincenzo Lenti
- Department of Internal Medicine, IRCCS San Matteo Hospital Foundation, Pavia, Italy; Department of Internal Medicine and Medical Therapeutics, University of Pavia, Pavia, Italy.
| | - Lavinia Pitotti
- Department of Internal Medicine, IRCCS San Matteo Hospital Foundation, Pavia, Italy; Department of Internal Medicine and Medical Therapeutics, University of Pavia, Pavia, Italy
| | - Gino Roberto Corazza
- Department of Internal Medicine, IRCCS San Matteo Hospital Foundation, Pavia, Italy; Department of Internal Medicine and Medical Therapeutics, University of Pavia, Pavia, Italy
| | - Antonio Di Sabatino
- Department of Internal Medicine, IRCCS San Matteo Hospital Foundation, Pavia, Italy; Department of Internal Medicine and Medical Therapeutics, University of Pavia, Pavia, Italy
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12
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Aygun E, Sayman OA, Erturk EY, Yılmaz Semerci S, Kanburoglu MK. An Implicit Cause of Prolonged Neonatal Jaundice: Vitamin B12 Deficiency. JOURNAL OF CHILD SCIENCE 2023. [DOI: 10.1055/s-0043-1761422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Abstract
Objective Prolonged jaundice is defined as a serum bilirubin level of more than 5 mg/dL, which persists at postnatal 14 days in term infants and 21 days following birth in preterm infants. Although the underlying causes cannot be found in the majority of prolonged jaundice cases, this may be the first sign of a serious issue. Therefore, this study aimed to evaluate the association between vitamin B12 deficiency and prolonged jaundice in newborns.
Material and Methods This descriptive cross-sectional study was performed in a university hospital between January 1, 2015 and October 1, 2020. All participants consisted of infants who were admitted to the pediatric outpatient clinics. Infants > 35 weeks of gestation and with prolonged jaundice of unknown etiology were included in the study group. The control group consisted of infants > 35 weeks of gestation without prolonged jaundice. Demographic and clinical characteristics and serum vitamin B12 levels were evaluated comparatively.
Results A total of 126 infants, 66 of whom had prolonged jaundice, were included. The mean gestational week of the study group was 38.4 ± 1.8, and the control group was 38.6 ± 1.9 weeks. There was no difference between the groups in terms of demographics and laboratory data. The vitamin B12 level of the study group was significantly lower (median = 170 pg/mL) than the control (median = 268 pg/mL).
Conclusion Based on the findings of this study, vitamin B12 deficiency was thought to be an important cause of prolonged jaundice, and further studies are needed to explain the role of vitamin B12 deficiency in the etiology of prolonged jaundice.
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Affiliation(s)
- Erhan Aygun
- Division of Neonatology, Health Sciences University, Istanbul Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
| | - Ozden Aksu Sayman
- Department of Pediatrics, Ordu University Training and Research Hospital, Ordu, Turkey
| | - Emine Yurdakul Erturk
- Department of Pediatrics, Ordu University Training and Research Hospital, Ordu, Turkey
| | - Seda Yılmaz Semerci
- Division of Neonatology, Health Sciences University, Istanbul Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Kenan Kanburoglu
- Division of Neonatology, Department of Pediatrics, Recep Tayyip Erdogan University, Rize, Turkey
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13
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Vitamin B12 (Cobalamin): Its Fate from Ingestion to Metabolism with Particular Emphasis on Diagnostic Approaches of Acquired Neonatal/Infantile Deficiency Detected by Newborn Screening. Metabolites 2022; 12:metabo12111104. [DOI: 10.3390/metabo12111104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/07/2022] [Accepted: 11/10/2022] [Indexed: 11/16/2022] Open
Abstract
Acquired vitamin B12 (vB12) deficiency (vB12D) of newborns is relatively frequent as compared with the incidence of inherited diseases included in newborn screening (NBS) of different countries across the globe. Infants may present signs of vB12D before 6 months of age with anemia and/or neurologic symptoms when not diagnosed in asymptomatic state. The possibility of identifying vitamin deficient mothers after their pregnancy during the breastfeeding period could be an additional benefit of the newborn screening. Vitamin supplementation is widely available and easy to administer. However, in many laboratories, vB12D is not included in the national screening program. Optimized screening requires either second-tier testing or analysis of new urine and blood samples combined with multiple clinical and laboratory follow ups. Our scope was to review the physiologic fate of vB12 and the pathobiochemical consequences of vB12D in the human body. Particular emphasis was put on the latest approaches for diagnosis and treatment of vB12D in NBS.
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14
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Acquired Vitamin B12 Deficiency in Newborns: Positive Impact on Newborn Health through Early Detection. Nutrients 2022; 14:nu14204397. [PMID: 36297083 PMCID: PMC9607322 DOI: 10.3390/nu14204397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 10/01/2022] [Accepted: 10/03/2022] [Indexed: 11/29/2022] Open
Abstract
The early diagnosis of and intervention in vitamin B12 deficiency in exclusively breastfed infants by mothers with low vitamin B12 is crucial in preventing possible irreversible neurologic damage, megaloblastic anemia, and failure to thrive. We assess the usefulness of the early detection of asymptomatic B12 deficiency related to acquired conditions and highlight the importance of monitoring serum vitamin B12 levels during pregnancy. We describe demographic, clinical, dietary, and biochemical data, including the evolution of a vitamin B12 deficiency’s functional biomarkers. We enrolled 12 newborns (5 males) with an age range of 1–2 months old that were exclusively breastfed and asymptomatic. These cases were referred to our metabolic unit due to alterations in expanded newborn screening: high levels of methylmalonic acid and/or total homocysteine (tHcy). All mothers were under a vegetarian diet except three who had abnormal B12 absorption, and all presented low or borderline serum B12 level and high plasma levels of tHcy. Supplementation with oral vitB12 re-established the metabolic homeostasis of the mothers. In infants, therapy with an intramuscular injection of 1.0 mg hydroxocobalamin led to the rapid normalization of the metabolic pattern, and a healthy outcome was observed. Acquired B12 deficiency should be ruled out before proceeding in a differential diagnosis of cobalamin metabolism deficits, methylmalonic acidemia, and homocystinuria.
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15
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Keskin EY, Keskin M, Karaibrahimoğlu A. Association of Maternal Vitamin B12 Status With Infant Findings and Neurodevelopment in Vitamin B12-Deficient Breast-fed Babies. J Pediatr Hematol Oncol 2022; 44:e91-e95. [PMID: 33661170 DOI: 10.1097/mph.0000000000002122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 01/24/2021] [Indexed: 11/25/2022]
Abstract
Few studies have examined the association between maternal vitamin B12 status and their breast-fed infants' findings. The objective of this study was to analyze the association of maternal B12 status with infant findings including neurodevelopmental outcome in breast-fed babies with B12 deficiency. Correlation analyses between the laboratory findings of infants with B12 deficiency (n=120) and their mothers were performed and the association of maternal B12 status with infant findings including the Denver-II developmental screening test (DDST II) results was examined. There was a significant correlation between infant and maternal B12 levels (r=0.222; P=0.030), and between infant and maternal homocysteine (Hcy) levels (r=0.390; P<0.001). Among the babies 4 months of age or older, maternal Hcy levels were significantly correlated with infant mean corpuscular hemoglobin (r=0.404; P=0.001) and infant mean corpuscular volume (r=0.461; P<0.001). Mothers of infants with abnormal DDST II had lower vitamin B12 (196.9±41.2 vs. 247.0±77.0 pg/mL; P=0.018) and higher Hcy levels (17.3±5.0 vs. 10.7±3.1 µmol/L; P<0.001) than mothers of infants with normal DDST II. A lower maternal vitamin B12 status may be related to impaired neurodevelopment in breast-fed infants with vitamin B12 deficiency. Pregnant and lactating women should be offered easy access to healthy nutrition and vitamin B12 supplements.
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Affiliation(s)
| | | | - Adnan Karaibrahimoğlu
- Biostatistics and Medical Informatics, Süleyman Demirel University Medical Faculty, Isparta, Turkey
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16
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Ljungblad UW, Paulsen H, Mørkrid L, Pettersen RD, Hager HB, Lindberg M, Astrup H, Eklund EA, Bjørke-Monsen AL, Rootwelt T, Tangeraas T. The prevalence and clinical relevance of hyperhomocysteinemia suggesting vitamin B12 deficiency in presumed healthy infants. Eur J Paediatr Neurol 2021; 35:137-146. [PMID: 34717141 DOI: 10.1016/j.ejpn.2021.10.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 10/05/2021] [Accepted: 10/13/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Previous studies have demonstrated a high prevalence of biochemical vitamin B12 deficiency in infants in Norway. Increased total homocysteine (tHcy) is the most important marker of B12 deficiency in infants. There is a need to evaluate its clinical relevance. AIMS To investigate the prevalence of hyperhomocysteinemia (S-tHcy > 8 μmol/L) suggestive of suboptimal B12 status and the prevalence of clinically relevant hyperhomocysteinemia in presumed healthy infants in Norway. Further, to evaluate risk factors, presence of symptoms and psychomotor development in these children. METHODS In a prospective study we clinically examined 252 infants aged 3-7 months using standardized neurological and psychomotor tests prior to analyzing biochemical B12 deficiency markers in 250 infants. RESULTS Twenty-five of 250 (10%) infants had hyperhomocysteinemia combined with clinically relevant symptoms suggestive of B12 deficiency. Hyperhomocysteinemia was associated with tremor, excessive sleep, and sub-normal scores in the fine motor section of the Ages and Stages Questionnaire. One-hundred and fourteen of 250 (46%) infants had hyperhomocysteinemia. Multiple regression analysis showed months of infant formula use as the strongest negative predictor for hyperhomocysteinemia. CONCLUSION We have demonstrated associations between symptoms suggestive of infant B12 deficiency and increased levels of tHcy in presumed healthy infants The combination of hyperhomocysteinemia and associated relevant symptoms suggestive of B12 deficiency was a common finding, albeit most infants with hyperhomocysteinemia did not show symptoms.
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Affiliation(s)
- Ulf Wike Ljungblad
- Institute of Clinical Medicine, University of Oslo, Postbox 1171 Blindern, NO-0318 Oslo, Norway; Department of Pediatrics, Vestfold Hospital Trust, Postbox 1068, NO-3103, Tønsberg, Norway.
| | - Henriette Paulsen
- Department of Rehabilitation and Physiotherapy, Vestfold Hospital Trust, Postbox 1068, NO-3103, Tønsberg, Norway.
| | - Lars Mørkrid
- Institute of Clinical Medicine, University of Oslo, Postbox 1171 Blindern, NO-0318 Oslo, Norway; Department of Medical Biochemistry, Oslo, University Hospital, Norway.
| | - Rolf D Pettersen
- Norwegian National Unit for Newborn Screening, Division of Pediatric and Adolescent Medicine, Oslo University Hospital, 0424, Oslo, Norway.
| | - Helle Borgstrøm Hager
- Department of Medical Biochemistry, Vestfold Hospital Trust, Postbox 1068, NO-3103, Tønsberg, Norway.
| | - Morten Lindberg
- Department of Medical Biochemistry, Vestfold Hospital Trust, Postbox 1068, NO-3103, Tønsberg, Norway.
| | - Henriette Astrup
- Department of Pediatrics and Adolescent Medicine, Sorlandet Hospital Trust, Postbox 416, NO-4604, Kristiansand, Norway.
| | - Erik A Eklund
- Department of Pediatrics, Clinical Sciences, Lund, Lund University, 221 84, Lund, Sweden.
| | - Anne-Lise Bjørke-Monsen
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway.
| | - Terje Rootwelt
- Institute of Clinical Medicine, University of Oslo, Postbox 1171 Blindern, NO-0318 Oslo, Norway; Department of Pediatrics, Division of Pediatric and Adolescent Medicine, Oslo University Hospital, 0424, Oslo, Norway.
| | - Trine Tangeraas
- Norwegian National Unit for Newborn Screening, Division of Pediatric and Adolescent Medicine, Oslo University Hospital, 0424, Oslo, Norway; Department of Pediatrics, Division of Pediatric and Adolescent Medicine, Oslo University Hospital, 0424, Oslo, Norway.
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17
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Fan D, Zhang Y, Wu H. Development of a simple and sensitive HPLC-DAD method for quantification of vitamin B12 fortified in infant food. ANALYTICAL METHODS : ADVANCING METHODS AND APPLICATIONS 2021; 13:4920-4925. [PMID: 34609384 DOI: 10.1039/d1ay01118a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
To prevent infants from vitamin B12 deficiency, infant food is designed based on cow's milk or cereal with the fortification of vitamin B12. A method for quantitative determination of vitamin B12 in infant food was developed with hydrophilic high performance liquid chromatography (HPLC) coupled with a diode array detector (DAD). The sensitivity of the detector was enhanced by implementing a 60 mm high-sensitivity LightPipe flow cell, and the limit of detection (LOD) and limit of quantification (LOQ) were improved as low as 0.006 μg 100 g-1 and 0.02 μg 100 g-1 respectively. The effect of sample extraction and enrichment, chromatography separation parameters on the analyte, were studied in detail and optimized. Under these conditions, the method performed a good linear analytical range of 0.3-50 μg L-1, and a good repeatability with % RSD below 2.8% and recovery of 90.2-96.5% (n = 6). To the best of our knowledge, for the first time, 60 mm high-sensitivity LightPipe flow cell was included in the HPLC-DAD method for determination of the trace amount of vitamin B12 in infant food. The proposed method was further validated by analysis of FAPAS QC samples (T21120 and T21118), and it was specific and precise for the intended use.
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Affiliation(s)
- Dingyan Fan
- Research and Development Department, GRA (Shanghai) Standard Technology Service Co., Ltd, Shanghai 201318, P. R. China.
| | - Yingzhou Zhang
- Research and Development Department, GRA (Shanghai) Standard Technology Service Co., Ltd, Shanghai 201318, P. R. China.
| | - Haiping Wu
- Research and Development Department, GRA (Shanghai) Standard Technology Service Co., Ltd, Shanghai 201318, P. R. China.
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18
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Rubini E, Baijens IMM, Horánszky A, Schoenmakers S, Sinclair KD, Zana M, Dinnyés A, Steegers-Theunissen RPM, Rousian M. Maternal One-Carbon Metabolism during the Periconceptional Period and Human Foetal Brain Growth: A Systematic Review. Genes (Basel) 2021; 12:1634. [PMID: 34681028 PMCID: PMC8535925 DOI: 10.3390/genes12101634] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/01/2021] [Accepted: 10/12/2021] [Indexed: 01/13/2023] Open
Abstract
The maternal environment during the periconceptional period influences foetal growth and development, in part, via epigenetic mechanisms moderated by one-carbon metabolic pathways. During embryonic development, one-carbon metabolism is involved in brain development and neural programming. Derangements in one-carbon metabolism increase (i) the short-term risk of embryonic neural tube-related defects and (ii) long-term childhood behaviour, cognition, and autism spectrum disorders. Here we investigate the association between maternal one-carbon metabolism and foetal and neonatal brain growth and development. Database searching resulted in 26 articles eligible for inclusion. Maternal vitamin B6, vitamin B12, homocysteine, and choline were not associated with foetal and/or neonatal head growth. First-trimester maternal plasma folate within the normal range (>17 nmol/L) associated with increased foetal head size and head growth, and high erythrocyte folate (1538-1813 nmol/L) with increased cerebellar growth, whereas folate deficiency (<7 nmol/L) associated with a reduced foetal brain volume. Preconceptional folic acid supplement use and specific dietary patterns (associated with increased B vitamins and low homocysteine) increased foetal head size. Although early pregnancy maternal folate appears to be the most independent predictor of foetal brain growth, there is insufficient data to confirm the link between maternal folate and offspring risks for neurodevelopmental diseases.
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Affiliation(s)
- Eleonora Rubini
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, 3000 CA Rotterdam, The Netherlands; (E.R.); (I.M.M.B.); (S.S.); (M.R.)
| | - Inge M. M. Baijens
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, 3000 CA Rotterdam, The Netherlands; (E.R.); (I.M.M.B.); (S.S.); (M.R.)
| | - Alex Horánszky
- Department of Physiology and Animal Health, Institute of Physiology and Animal Health, Hungarian University of Agriculture and Life Sciences, H-2100 Gödöllő, Hungary; (A.H.); (A.D.)
- BioTalentum Ltd., H-2100 Gödöllő, Hungary;
| | - Sam Schoenmakers
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, 3000 CA Rotterdam, The Netherlands; (E.R.); (I.M.M.B.); (S.S.); (M.R.)
| | - Kevin D. Sinclair
- School of Biosciences, University of Nottingham, Nottingham LE12 5RD, UK;
| | | | - András Dinnyés
- Department of Physiology and Animal Health, Institute of Physiology and Animal Health, Hungarian University of Agriculture and Life Sciences, H-2100 Gödöllő, Hungary; (A.H.); (A.D.)
- BioTalentum Ltd., H-2100 Gödöllő, Hungary;
- HCEMM-USZ Stem Cell Research Group, Hungarian Centre of Excellence for Molecular Medicine, H-6723 Szeged, Hungary
- Department of Cell Biology and Molecular Medicine, University of Szeged, H-6720 Szeged, Hungary
| | - Régine P. M. Steegers-Theunissen
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, 3000 CA Rotterdam, The Netherlands; (E.R.); (I.M.M.B.); (S.S.); (M.R.)
| | - Melek Rousian
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, 3000 CA Rotterdam, The Netherlands; (E.R.); (I.M.M.B.); (S.S.); (M.R.)
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19
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BEYOĞLU MM, KÖSTÜ B. Gebe Popülasyonunda Vitamin B12 Düzeyinin Değerlendirilmesi ve Beslenme Yetersizliği ile İlişkisi. KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNIVERSITESI TIP FAKÜLTESI DERGISI 2021. [DOI: 10.17517/ksutfd.971131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Amaç: Gebe popülasyonunda vitamin B12 düzeyini incelemek, yetersizlik ve eksiklik durumlarında beslenme bozukluğu ile ilişkisini araştırmak, erken teşhisle takviyesini başlamak.
Gereç-Yöntemler: Üçüncü basamak bir üniversite hastanesi tıp fakültesi kadın doğum ve hastalıkları anabilim dalına başvuran gebelik tanılı hastaların ultrasonografi verileri, rutin kan değerleri ve vitamin B12 verileri kaydedildi. Verilerin değerlendirilmesinde SPSS 22.0 istatistik programı kullanıldı. P
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20
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Maternal vitamin B12 deficiency and perinatal outcomes in southern India. PLoS One 2021; 16:e0248145. [PMID: 33822790 PMCID: PMC8023483 DOI: 10.1371/journal.pone.0248145] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 02/19/2021] [Indexed: 12/16/2022] Open
Abstract
Background Vitamin B12 deficiency during pregnancy has been associated with adverse maternal and infant health outcomes. Few prospective studies have investigated vitamin B12 status early in pregnancy, and its links to infant vitamin B12 status, particularly in India where the burden of vitamin B12 deficiency is estimated to be the highest globally. The objective of this study was to examine the associations of maternal vitamin B12 biomarkers with neonatal vitamin B12 status. Methods Pregnant women (~12 weeks’ gestation) were enrolled in a perinatal cohort study in Bangalore, India. Total vitamin B12, methylmalonic acid (MMA), and homocysteine concentrations were evaluated in maternal samples at enrollment and in neonates at birth using cord blood. Linear and binomial regression models were used to evaluate the associations of maternal vitamin B12 biomarkers with neonatal vitamin B12 status and perinatal outcomes. Results A total of 63.2% of women had vitamin B12 deficiency (<148 pmol/L), 87.2% had vitamin B12 insufficiency (<221 pmol/L), and 47.3% had impaired vitamin B12 status (vitamin B12<148 pmol/L and MMA>0.26μmol/L) at enrollment; 40.8% of neonates had vitamin B12 deficiency, 65.6% were insufficiency, and 38.1% had impaired vitamin B12 status at birth. Higher maternal vitamin B12 concentrations at enrollment were associated with increased neonatal vitamin B12 concentrations (β(SE): 0.40 (0.05); p<0.0001) and lower risk of neonatal vitamin B12 deficiency (Risk Ratio [RR]: 0.53; 95% CI: [0.43, 0.65]; p<0.0001). Maternal vitamin B12 deficiency (RR: 1.97 [1.43, 2.71]; p<0.001), insufficiency (RR: 2.18 [1.23, 3.85]; p = 0.007), and impaired vitamin B12 status (RR: 1.49 [1.13, 1.97]; p = 0.005) predicted a two-fold increase in the risk of neonatal vitamin B12 deficiency at birth. Conclusions The prevalence of vitamin B12 deficiency was high early in pregnancy and predicted neonatal vitamin B12 status. Future research is needed to determine the role of vitamin B12 in the development of pregnancy and infant outcomes, and to inform screening and interventions to improve maternal and child health.
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D'souza N, Behere RV, Patni B, Deshpande M, Bhat D, Bhalerao A, Sonawane S, Shah R, Ladkat R, Yajnik P, Bandyopadhyay SK, Kumaran K, Fall C, Yajnik CS. Pre-conceptional Maternal Vitamin B12 Supplementation Improves Offspring Neurodevelopment at 2 Years of Age: PRIYA Trial. Front Pediatr 2021; 9:755977. [PMID: 34956975 PMCID: PMC8697851 DOI: 10.3389/fped.2021.755977] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 11/08/2021] [Indexed: 12/04/2022] Open
Abstract
Background: The first thousand days window does not include the pre-conceptional period. Maternal pre-conceptional health has a profound influence on early embryonic development (implantation, gastrulation, placentation etc). Nutrition provided by B-complex vitamins is important for fetal growth, especially neural development. We report effects of a maternal pre-conceptional vitamin B12 and multi micronutrient (MMN) supplementation on offspring neurodevelopmental performance. Methods: In the Pune Rural Intervention in Young Adolescents trial (PRIYA), adolescents (N = 557, 226 females) were provided with vitamin B12 (2 μg/day) with or without multiple micronutrients, or a placebo, from preconception until delivery. All groups received mandatory iron and folic acid. We used the Bayley's Scale of Infant Development (BSID-III) at 24-42 months of age to investigate effects on offspring neurodevelopment. Results: Participants had similar baseline B12 levels. The levels improved in the B12 supplemented groups during pre-conception and pregnancy (28 weeks gestation), and were reflected in higher cord blood holotranscobalamin (holo-TC) levels compared to the placebo group. Neurodevelopmental outcomes in the B12 alone group (n = 21) were better than the placebo (n = 27) in cognition (p = 0.044) and language (p = 0.020) domains (adjusted for maternal baseline B12 levels). There was no difference in neurodevelopmental outcomes between the B12 + MMN (n = 26) and placebo group. Cord blood Brain Derived Neurotrophic Factor (BDNF) levels were highest in the B12 alone group, though not significant. Conclusion: Pre-conceptional vitamin B12 supplementation improved maternal B12 status and offspring neurodevelopment at 2 years of age. The usefulness of cord BDNF as a marker of brain development needs further investigation. Our results highlight the importance of intervening during pre-conception.
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Affiliation(s)
- Naomi D'souza
- Diabetes Unit, King Edward Memorial Hospital Research Center, Pune, India
| | - Rishikesh V Behere
- Diabetes Unit, King Edward Memorial Hospital Research Center, Pune, India
| | - Bindu Patni
- Terre des Hommes Rehabilitation and Morris Child Development Centre at KEM Hospital, Pune, India
| | - Madhavi Deshpande
- Terre des Hommes Rehabilitation and Morris Child Development Centre at KEM Hospital, Pune, India
| | - Dattatray Bhat
- Diabetes Unit, King Edward Memorial Hospital Research Center, Pune, India
| | - Aboli Bhalerao
- Diabetes Unit, King Edward Memorial Hospital Research Center, Pune, India
| | - Swapnali Sonawane
- Diabetes Unit, King Edward Memorial Hospital Research Center, Pune, India
| | - Rohan Shah
- Diabetes Unit, King Edward Memorial Hospital Research Center, Pune, India
| | - Rasika Ladkat
- Diabetes Unit, King Edward Memorial Hospital Research Center, Pune, India
| | - Pallavi Yajnik
- Diabetes Unit, King Edward Memorial Hospital Research Center, Pune, India
| | | | - Kalyanaraman Kumaran
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
| | - Caroline Fall
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
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22
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Bordoni L, Petracci I, Calleja-Agius J, Lalor JG, Gabbianelli R. NURR1 Alterations in Perinatal Stress: A First Step towards Late-Onset Diseases? A Narrative Review. Biomedicines 2020; 8:E584. [PMID: 33302583 PMCID: PMC7764589 DOI: 10.3390/biomedicines8120584] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/04/2020] [Accepted: 12/07/2020] [Indexed: 12/12/2022] Open
Abstract
Perinatal life represents a delicate phase of development where stimuli of all sorts, coming to or from the mother, can influence the programming of the future baby's health. These stimuli may have consequences that persist throughout adulthood. Nuclear receptor related 1 protein (NURR1), a transcription factor with a critical role in the development of the dopaminergic neurons in the midbrain, mediates the response to stressful environmental stimuli in the perinatal period. During pregnancy, low-grade inflammation triggered by maternal obesity, hyperinsulinemia or vaginal infections alters NURR1 expression in human gestational tissues. A similar scenario is triggered by exposure to neurotoxic compounds, which are associated with NURR1 epigenetic deregulation in the offspring, with potential intergenerational effects. Since these alterations have been associated with an increased risk of developing late-onset diseases in children, NURR1, alone, or in combination with other molecular markers, has been proposed as a new prognostic tool and a potential therapeutic target for several pathological conditions. This narrative review describes perinatal stress associated with NURR1 gene deregulation, which is proposed here as a mediator of late-onset consequences of early life events.
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Affiliation(s)
- Laura Bordoni
- Unit of Molecular Biology and Nutrigenomics, School of Pharmacy, University of Camerino, 62032 Camerino, Italy;
| | - Irene Petracci
- School of Advanced Studies, University of Camerino, 62032 Camerino, Italy;
| | - Jean Calleja-Agius
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, MSD2080 Msida, Malta;
| | - Joan G. Lalor
- School of Nursing and Midwifery, Trinity College Dublin, 24 D’Olier Street, Dublin 2, Ireland;
| | - Rosita Gabbianelli
- Unit of Molecular Biology and Nutrigenomics, School of Pharmacy, University of Camerino, 62032 Camerino, Italy;
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Association of antenatal vitamin B complex supplementation with neonatal vitamin B 12 status: evidence from a cluster randomized controlled trial. Eur J Nutr 2020; 60:1031-1039. [PMID: 32577886 DOI: 10.1007/s00394-020-02309-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 06/15/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Evidence about the effect of maternal vitamin B12 supplementation on offspring's vitamin B12 status is limited. The present interventional study sought to evaluate the association of antenatal vitamin B complex supplementation with neonatal vitamin B12 status. METHODS In an ongoing cluster randomized controlled trial conducted in three rural counties in northwest China, pregnant women < 20 weeks of gestation were randomized to three treatment groups: blank control, iron supplements, or vitamin B complex supplements. All women were administered folic acid supplements during the periconceptional period. In a sub-study, we collected cord blood samples of 331 participants from the control or vitamin B complex groups in the Xunyi county from January 2017 to December 2017. Plasma concentrations of folate, vitamin B12, and homocysteine were measured. Linear mixed models with a random intercept for cluster were used to compare biochemical indexes between groups after controlling for covariates. RESULTS Compared with newborns whose mothers were in the control group, newborns of the vitamin B complex-supplemented women had significantly higher cord plasma vitamin B12 (P = 0.001) and lower homocysteine concentrations (P = 0.043). The association of antenatal vitamin B complex supplementation with cord blood vitamin B12 concentrations appeared to be more pronounced among newborns with high folate status than those with low folate status (Pinteraction = 0.060). CONCLUSIONS Maternal vitamin B complex supplementation during pregnancy was associated with better neonatal vitamin B12 status in rural northwest China.
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Thomas S, Vigil E, Thomas T, Bellinger DC, Ramthal A, Kurpad AV, Duggan CP, Srinivasan K. Antenatal Depressive Symptoms and Neurodevelopment Outcomes in Children at 30 Months. A Study From South India. Front Psychiatry 2020; 11:486175. [PMID: 33192637 PMCID: PMC7541826 DOI: 10.3389/fpsyt.2020.486175] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Accepted: 09/07/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Prevalence of antenatal depression in low and middle income countries is high. However studies examining the association between maternal antenatal depression and early childhood development from these countries are scarce. The objective of the study was to examine the association between antenatal depressive symptoms assessed serially during pregnancy and child neurodevelopment outcomes in mother-child dyads part of a randomized control trial of maternal B12 supplementation during pregnancy. METHOD Subjects were 203 women who had participated in the placebo-controlled, randomized trial of vitamin B12 supplementation during pregnancy and 6 weeks post-partum on whom serial assessments of depressive symptoms in each of the trimesters were available. Cognitive, receptive language, expressive language, fine motor skills and gross motor skills were assessed at 30 months using the Bayley's Scale of Infant Development-3rd edition (BSID-III). Antenatal depressive symptoms were assessed at three trimesters using the Kessler's 10 Psychological Distress Scale (K10). Women were classified into three categories: not depressed (K10 <6 in all trimesters), with intermittent depressive symptoms (K10 ≥6 in at least one trimester) and with persistent depressive symptoms (K10 score ≥6 in at least 2 trimesters). RESULTS 112 (55.2%) of the women did not have depressive symptoms, 58 (28.6%) had intermittent depressive symptoms and 33 (16.2%) had persistent depressive symptoms. The children of women with intermittent antenatal depressive symptoms scored lower on the receptive language domain on BSID-III compared to children of women who were not depressed on univariate analysis, but not on bivariate regression analysis. Women with persistent depressive symptoms had lower educational attainment (p = 0.004), lower social support (p = 0.006) and used more emotional coping strategies (p = 0.005) compared to the not depressed group. CONCLUSIONS A significant number of women in south India had antenatal depressive symptoms. Findings from this study suggest a possible association between antenatal depressive symptoms and receptive language in children. Larger studies including women with clinical depression are needed to confirm these findings.
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Affiliation(s)
- Susan Thomas
- Division of Mental Health & Neurosciences, St John's Research Institute, Bengaluru, India
| | - Emelia Vigil
- Department of Psychology, Harvard University, Cambridge, MA, United States
| | - Tinku Thomas
- Division of Epidemiology, Biostatistics and Population Health, St John's Research Institute, Bengaluru, India
| | - David C Bellinger
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Asha Ramthal
- Division of Mental Health & Neurosciences, St John's Research Institute, Bengaluru, India
| | - Anura V Kurpad
- Division of Nutrition, St John's Research Institute, Bengaluru, India.,Department of Physiology, St Johns Medical College, Bengaluru, India
| | - Christopher P Duggan
- Division of Nutrition, St John's Research Institute, Bengaluru, India.,Center for Nutrition, Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, MA, United States
| | - Krishnamachari Srinivasan
- Division of Mental Health & Neurosciences, St John's Research Institute, Bengaluru, India.,Department of Psychiatry, St John's Medical College, Bengaluru, India
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Crozier SR, Godfrey KM, Calder PC, Robinson SM, Inskip HM, Baird J, Gale CR, Cooper C, Sibbons CM, Fisk HL, Burdge GC. Vegetarian Diet during Pregnancy Is Not Associated with Poorer Cognitive Performance in Children at Age 6-7 Years. Nutrients 2019; 11:nu11123029. [PMID: 31835868 PMCID: PMC6949927 DOI: 10.3390/nu11123029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 12/05/2019] [Accepted: 12/10/2019] [Indexed: 12/26/2022] Open
Abstract
Compared with omnivorous mothers, vegetarian mothers have lower intakes of some nutrients required for neurological development. However, there is a lack of information about the impact of vegetarianism during pregnancy on subsequent cognitive function in children. The aim of this study was to investigate whether vegetarianism during pregnancy is associated with altered maternal nutritional status and with cognitive function in children at six to seven years of age. Women aged 20–34 years participating in a prospective observational study who provided dietary data and blood samples in early pregnancy (11 weeks; 78 vegetarians and 2144 omnivores) or late pregnancy (34 weeks; 91 vegetarians and 2552 omnivores). Compared with omnivorous women, vegetarian women had lower blood concentrations of arachidonic acid, docosahexaenoic acid, and cobalamin in early and late pregnancy. Vegetarianism in pregnancy was linked to higher maternal educational attainment, longer breastfeeding duration, lower incidence of smoking during pregnancy and a tendency towards higher IQ in the mothers. Concentrations of some nutrients required for neurodevelopment were lower in maternal blood during gestation; however, after controlling for confounders consuming a vegetarian diet during pregnancy was not associated with poorer neurocognitive development of the children in this study.
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Affiliation(s)
- Sarah R. Crozier
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton SO16 6YD, UK
| | - Keith M. Godfrey
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton SO16 6YD, UK
| | - Philip C. Calder
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton SO16 6YD, UK
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - Sian M. Robinson
- AGE Research Group, Newcastle University, Newcastle upon Tyne NE4 5PL, UK
- NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Newcastle upon Tyne NE4 5PL, UK
| | - Hazel M. Inskip
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton SO16 6YD, UK
| | - Janis Baird
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton SO16 6YD, UK
| | - Catharine R. Gale
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton SO16 6YD, UK
- Centre for Cognitive Ageing & Cognitive Epidemiology, Department of Psychology, University of Edinburgh, Edinburgh EH8 9AZ, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton SO16 6YD, UK
| | - Charlene M. Sibbons
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - Helena L. Fisk
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - Graham C. Burdge
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
- Correspondence: ; Tel.: +44-(0)23-812-05259
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