ICNC Abstracts, ICNC 2018

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Assessment of Vitamin B-12 deficiency and Risk Factors in Healthy Infants: A Cross-sectional Study
Kuchana Suresh Kumar, Savita Attri, Arushi Gahlot Saini, Bhavneet Bharti, Naveen Sankhyan, Prateek Bhatia, Ajay Patial

Last modified: 2018-09-09

Abstract


Objective: We aimed to study vitamin B12 deficiency in apparently healthy infants and their mothers and assess its risk factors.

Methodology: Hospital-based, cross-sectional, observational study conducted from July 2016 to 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.

Results: 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 was 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 (IQR 4.4-13.1). 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 levels (OR 5.42; 95% CI:1.96-16.6; p 0.002).

Conclusion: 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.


Keywords


Vitamin B12; Cobalamin; Homocysteine; Methylmalonic acid; Maternal B12

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