Assessment of Vitamin B12 Deficiency and Risk Factors in Healthy Infants.

Kuchana Suresh Kumar, Arushi Gahlot Saini, Savita Verma Attri, Bhavneet Bharti, Naveen Sankhyan, Prateek Bhatia

Indian journal of pediatrics 2021 Jan

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To study vitamin B12 deficiency in apparently healthy infants and their mothers and assess the risk factors. A hospital-based, cross-sectional, observational study was conducted from July 2016 through December 2017. Consecutive healthy and normally developing infants were enrolled. Red blood cell folate, plasma vitamin B12, homocysteine and methylmalonic acid levels of mothers and infants were assessed. Seventy-four healthy infants were enrolled. Male-to-female ratio was 1.5:1. Anemia in 66.2% (n = 49), low plasma B12 in 17.6% (n = 13), hyperhomocysteinemia in 48.6% (n = 36), plasma methylmalonic acid in 100% (n = 74) and 'confirmed' B12 deficiency in 38% (n = 28) infants were noted. The proportion of hyperhomocysteinemia increased to 75.7% (n = 56) infants using a lower cut-off of >10 μmol/L. In mothers, low B12 in 19%, hyperhomocysteinemia in 57% and elevated plasma methylmalonic acid in 100% were noted. Median plasma B12 level was 314 pg/ml (IQR 221-421), median plasma homocysteine 15.4 μmol/L (IQR 11.3-21.7) and median plasma methylmalonic acid was 8.28 μmol/L (IQR 4.4-13.1) in mothers. Folate deficiency was noted in 9.4% infants and 12% of mothers. Overall, 63.5% mothers were vegetarian and, 64% of the mothers of infants with confirmed vitamin B12 deficiency were pure vegetarians. Odds of developing vitamin B12 deficiency increased by more than 5 times in those whose mothers' serum vitamin B12 levels were low as compared to normal maternal vitamin B12 levels (OR 5.42; 95% CI: 1.96-16.6; p 0.002). There is a high prevalence of vitamin B12 deficiency in infants and their mothers. There is urgent need to supplement our population with vitamin B12.

Citation

Kuchana Suresh Kumar, Arushi Gahlot Saini, Savita Verma Attri, Bhavneet Bharti, Naveen Sankhyan, Prateek Bhatia. Assessment of Vitamin B12 Deficiency and Risk Factors in Healthy Infants. Indian journal of pediatrics. 2021 Jan;88(1):41-49