Vitamin B12 Supplementation Of Bangladeshi Women In Pregnancy And Lactation: Effects On Maternal And Infant Status, Breast Milk And Immunity

Vitamin B12 deficiency is highly prevalent in Bangladesh and other countries with low animal source food intake. Poor B12 status is associated with several adverse outcomes in pregnancy and infancy, and low breast milk B12; however no B12 supplementation trials have been carried out in pregnant women. In a pilot study, women (n=69, 18–35 y, Hb <115 g/L, 11–14 wk pregnant) were randomized to 250 ug B12/d or placebo through 4 mo postpartum. Both groups also received 400 ug folic acid + 60 mg Fe. Women were immunized with HINI vaccine at 26–28 wk gestation. There were no sig. differences between groups at baseline, when 26% women were B12 deficient (<150 pM), 41% had marginal status (150–221 pM), 26% elevated MMA and 61% tHcy (>;8uM). Supplementation increased plasma B12 and lowered MMA in cord blood and in mothers and infants at 4 mo; it also reduced tHcy in cord blood and infants (all P<0.001) but not in mothers of whom 12% remained elevated (>;12 uM) after supplementation. Hematology, iron status indicators and H1N1 antibody titer did not respond to B12 supplementation. Median B12 in colostrum of the suppl.group increased to 778 vs. 320 pM in the placebo group (P<0.001), and 235 vs. 170 pM at 4 mo (P<0.05) in breast milk. Maternal plasma B12 at baseline remained correlated (r=0.446) with concentrations at 4 mo in spite of supplementation. Maternal and infant B12 status sig. improved by 250 ug/d supplements through pregnancy and lactation. Grant Funding Source : Nestle Foundation, SIDA, and USDA, ARS WHNRC