Abstract
Vitamin B12 (B12) adequacy during pregnancy is crucial for maternal health and optimal fetal development; however, suboptimal B12 status has been reported in pregnant Canadian women. Methylmalonic acid (MMA) is a sensitive indicator of B12 status. Since few studies have measured MMA during pregnancy in Canadian women, the objective of this study was to evaluate B12 status in pregnant women living in Metro Vancouver, using both plasma total B12 and MMA. We recruited a convenience sample of 320 pregnant women between 20 and 35 gestational weeks from local healthcare facilities. Plasma total B12 concentrations indicative of deficiency (<148 pmol/L) and suboptimal B12 status (148–220 pmol/L) were found in 18% and 33% of the women, respectively. Normal plasma MMA concentration (<210 nmol/L) was observed in 82% of all women. Gestational age was a strong predictor of plasma total B12 and MMA concentration, and South Asian ethnicity of B-12 deficiency and MMA concentrations. Overall, there was a high discrepancy between the prevalence of B12 inadequacy depending on the biomarker used. Independently, however, South Asian women were at particular risk for B12 deficiency, likely due to lower animal source food intake. Further study of this vulnerable group and performance testing of B12 biomarkers is warranted.
Highlights
Maternal vitamin B12 (B12) adequacy is important for fetal growth and neurodevelopment, and for maternal and infant health
Multivariate logistic regression revealed that the odds of being B12 deficient were about 10-times higher for those who self-identified as South Asians relative to those who identified as European (Table 3)
Concentrations in South Asian women compared to other ethnicities, and determined that the odds of being B12 deficient and having elevated Methylmalonic acid (MMA) concentration were about 10-times and 5-times higher, respectively, for those who self-identified as South Asians relative to those who identified as European
Summary
Maternal vitamin B12 (B12) adequacy is important for fetal growth and neurodevelopment, and for maternal and infant health. Low maternal B12 status has been associated with preterm birth [1], intra-uterine growth restriction [2], congenital heart defects [3], neural tube defects (NTDs) [4], and impaired cardiometabolic health in the offspring [5,6]. Maternal B12 status is a key determinant of infant B12 status [7,8]. Poor infant B12 status can have irreversible long-term consequences, including poor intellectual and cognitive performance later in childhood [9]. In the Canadian Health Measures Survey (Cycle 1; 2007–2009), suboptimal B12 status B12 =148–220 pmol/L) and B12 deficiency (serum total B12
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