Abstract
Objective: The aim of this study is to evaluate vitamin B12, folate, and homocysteine status in pregnant women in the third trimester of pregnancy and their relationship to fetal birth weight and their correlation to corresponding neonatal cord blood levels, and in addition, to evaluate the possibility of maternal serum homocysteine level as a predictor of low birth weight infants. Subjects and Methods: In this cross-sectional study, a total of two hundred pregnant women in third trimester (≥28 weeks) were recruited. After a detailed obstetrical and medical history, and clinical assessment, participants were subdivided into two groups: Group (A)—pregnant women who delivered average birth weight (ABW) infants and Group (B) for those who delivered low birth weight (LBW) infants between completed 37 and 42 weeks. Results: Vitamin B12 deficiency was observed in 24.1% of the total cohort. The mean vitamin B12 level was significantly lower in group (B) compared to group (A) (195.2 ± 38.9 vs. 225.9 ± 66.59 respectively P = 0.008). The mean level of homocysteine for women in group (B) was significantly higher than those determined from women in group (A) (9.10 ± 5.9 vs. 7.6 ± 3.83 respectively, P = 0.042). On the other hand, the mean folate levels showed statistically insignificant differences between both groups. The mean cord vitamin B12 level was significantly lower in LBW infants in comparison to ABW infants (277 ± 61.93 vs. 312.03 ± 81.87 respectively, P = 0.015), while the mean level of cord homocysteine for LBW infants was significantly higher than those levels determined from ABW infants (7.9 ± 3.79 vs. 6.6 ± 2.09 respectively P = 0.0049). Conclusion: Maternal micronutrients particularly cobalamin deficiency could be significant risk for LBW infants. Hyperhomocysteinemia has been shown to be a predictor for adverse pregnancy outcomes particularly LBW.
Highlights
Pregnancy is a period of fetal growth and development which necessitates increase in the nutrients [1]
The mean cord vitamin B12 level was significantly lower in low birth weight (LBW) infants in comparison to average birth weight (ABW) infants (277 ± 61.93 vs. 312.03 ± 81.87 respectively, P = 0.015), while the mean level of cord homocysteine for LBW infants was significantly higher than those levels determined from ABW infants
The aim of this study is to evaluate vitamin B12, folate, and homocysteine status in pregnant women in the third trimester of pregnancy and their relationship to fetal birth weight, and in addition, to investigate the correlation between maternal micronutrients to their corresponding neonatal cord blood levels, and the possibility of maternal serum homocysteine level to be a predictor of LBW
Summary
Pregnancy is a period of fetal growth and development which necessitates increase in the nutrients [1]. A pregnant woman requires extra amounts of most essential nutrients, including iron, vitamin B12 and folic acid [2]. These maternal micronutrients are involved in the one-carbon metabolism (1-C) required for methylation capacity which can cause adverse metabolic processes. Vitamin B12 (cobalamin) is a micronutrient coenzyme synthesized in the liver and called as extrinsic factor essential for DNA, and RNA synthesis, erythropoiesis, and proteins, and lipids synthesis in the cytoplasm [3]. Severe cobalamin deficiency leads to insufficient DNA synthesis which results in pernicious anemia and neuropsychiatric symptoms which cannot coexist with pregnancy [6]. In a recent systemic review, cobalamin insufficiency reported to be common among pregnant women in all trimesters by 20% - 30% [7]
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