Association between Maternal Vitamin B-12 Deficiency and Early Neurodevelopmental Biomarkers in Breastfed Neonates
Vitamin B-12 Deficiency and Neurodevelopmental Biomarkers in Breastfed Neonates
DOI:
https://doi.org/10.54393/pjhs.v6i8.3345Keywords:
Vitamin B-12 Deficiency, Maternal Nutrition, Neurodevelopment, Neonates, Breastfeeding, Cognitive Score, Motor Development, Early BiomarkersAbstract
Vitamin B-12 plays a vital role in fetal brain development and early neurological function. Exclusively breastfed neonates are highly dependent on maternal B-12 stores and are at increased risk for early neurodevelopmental deficits in cases of maternal deficiency. However, evidence on this association during the neonatal period remains limited, especially in low-resource settings. Objectives: To assess the association between maternal vitamin B-12 deficiency and early neurodevelopmental outcomes in exclusively breastfed neonates within the first month of life. Methods: This cross-sectional analytical study was conducted on 91 mother-infant pairs. Maternal serum B-12 levels were measured postpartum, and infants were evaluated within the first 28 days using standardized neurodevelopmental assessments, including cognitive, motor, and language scores, as well as clinical markers like visual tracking, muscle tone, and developmental reflexes. Data were analyzed using SPSS, version 26.0 and associations were tested through independent t-tests and Chi-square analyses (p<0.05 considered significant). Results: Vitamin B-12 deficiency was found in 35.2% of mothers. Among the exclusively breastfed subgroup (n=46), no statistically significant differences were observed in cognitive (p=0.480), motor (p=0.473), or language scores (p=0.544) between neonates of B-12-deficient and B-12-sufficient mothers. Similarly, visual tracking deficits, abnormal muscle tone, and neurodevelopmental delay showed no significant associations with maternal B-12 status. Conclusions: Maternal vitamin B-12 deficiency did not demonstrate a measurable impact on early neurodevelopmental biomarkers in exclusively breastfed neonates during the first month of life. Larger longitudinal studies are needed to determine long-term consequences and guide maternal nutrition policies.
References
Tangeraas T, Ljungblad UW, Lutvica E, Kristensen E, Rowe AD, Bjørke-Monsen AL et al. Vitamin B12 Deficiency (Un-) Detected Using Newborn Screening in Norway. International Journal of Neonatal Screening. 2023 Jan; 9(1): 3. doi: 10.3390/ijns9010003. DOI: https://doi.org/10.3390/ijns9010003
Bjørke-Monsen AL. Defining Optimal Cobalamin Status for Neonates and Infants. Food and Nutrition Bulletin. 2024 Jun; 45(1_suppl): S16-22. doi: 10.1177/03795721241227782. DOI: https://doi.org/10.1177/03795721241227782
Kadiyala A, Palani A, Rajendraprasath S, Venkatramanan P. Prevalence of Vitamin B12 Deficiency Among Exclusively Breast Fed Term Infants in South India. Journal of Tropical Paediatrics. 2021 Feb; 67(1): fmaa114. doi: 10.1093/tropej/fmaa114. DOI: https://doi.org/10.1093/tropej/fmaa114
Chen Y, Che X, Raghavan R. Distribution and Correlates of Plasma Folate, Vitamin B12, and Homocysteine in A Sample of Low-Income Minority Children Aged 6 Months to 9 Years in the US. Precision Nutrition. 2024 Jun; 3(2): e00074. DOI: https://doi.org/10.1097/PN9.0000000000000074
Kumar KS, Saini AG, Attri SV, Bharti B, Sankhyan N, Bhatia P. Assessment of Vitamin B12 Deficiency and Risk Factors in Healthy Infants. The Indian Journal of Paediatrics. 2021 Jan; 88(1):41-9. doi: 10.1007/s12098-020-03413-w. DOI: https://doi.org/10.1007/s12098-020-03413-w
Karak P, Modak A, Manna I. Nutritional Benefits of Vitamin B Complex for a Healthy Pregnancy. In Dietary Supplements and Nutraceuticals. Singapore: Springer Nature Singapore. 2025 Jun: 1-29. doi: 10.1007/978-981-97-9936-7_18-1. DOI: https://doi.org/10.1007/978-981-97-9936-7_18-1
Keskin EY, Keskin M, Karaibrahimoğlu A. Association of Maternal Vitamin B12 Status with Infant Findings and Neurodevelopment in Vitamin B12-Deficient Breast-Fed Babies. Journal of Pediatric Hematology/Oncology. 2022 Jan; 44(1): e91-5. doi: 10.1097/MPH.0000000000002122. DOI: https://doi.org/10.1097/MPH.0000000000002122
Cruz-Rodríguez J, Díaz-López A, Canals-Sans J, Arija V. Maternal Vitamin B12 Status During Pregnancy and Early Infant Neurodevelopment: The ECLIPSES Study. Nutrients. 2023 Mar; 15(6): 1529. doi: 10.3390/nu15061529. DOI: https://doi.org/10.3390/nu15061529
Solvik BS, Bakken KS, McCann A, Ueland PM, Henjum S, Strand TA. Breastfeeding and Biomarkers of Folate and Cobalamin Status in Norwegian Infants: A Cross-Sectional Study. Journal of Nutritional Science. 2024 Jan; 13: e40. doi: 10.1017/jns.2024.54. DOI: https://doi.org/10.1017/jns.2024.54
Wirthensohn M, Wehrli S, Ljungblad UW, Huemer M. Biochemical, Nutritional, and Clinical Parameters of Vitamin B12 Deficiency in Infants: A Systematic Review and Analysis of 292 Cases Published Between 1962 and 2022. Nutrients. 2023 Nov; 15(23): 4960. doi: 10.3390/nu15234960. DOI: https://doi.org/10.3390/nu15234960
Bjørkevoll SM, O'Keeffe M, Konijnenberg C, Solvik BS, Sødal AF, Kaldenbach S et al. Infant Vitamin B12 Status and its Predictors–Cross-Sectional Baseline Results from an Ongoing Randomized Controlled Trial. The American Journal of Clinical Nutrition. 2025 Jul. doi: 10.1016/j.ajcnut.2025.06.029. DOI: https://doi.org/10.1016/j.ajcnut.2025.06.029
Siddiqua TJ, Akhtar E, Haq MA, Shahab-Ferdows S, Hampel D, Islam S et al. Effects of Vitamin B12 Supplementation on Oxidative Stress Markers and Pro-Inflammatory Cytokines During Pregnancy and Postpartum among Bangladeshi Mother–Child Pairs. BioMed Central Nutrition. 2024 Jan; 10(1): 3. doi: 10.1186/s40795-023-00785-y. DOI: https://doi.org/10.1186/s40795-023-00785-y
Aref M, Golastani B, Heidari-Beni M, Bemanalizadeh M, Kelishadi R. Maternal Nutrition and Child Neurodevelopment. InNature, Nurture, and Neurodevelopment: Comprehensive Overview. Singapore: Springer Nature Singapore. 2024 Dec: 79-90. doi: 10.1007/978-981-97-7433-3_6. DOI: https://doi.org/10.1007/978-981-97-7433-3_6
Ljungblad UW, Astrup H, Mørkrid L, Hager HB, Lindberg M, Eklund EA et al. Breastfed Infants with Spells, Tremor, or Irritability: Rule Out Vitamin B12 Deficiency. Pediatric Neurology. 2022 Jun; 131: 4-12. doi: 10.1016/j.pediatrneurol.2022.03.003. DOI: https://doi.org/10.1016/j.pediatrneurol.2022.03.003
Ulak M, Kvestad I, Chandyo RK, Ranjitkar S, Hysing M, Schwinger C et al. The Effect of Infant Vitamin B12 Supplementation on Neurodevelopment: A Follow-Up of a Randomised Placebo-Controlled Trial in Nepal. British Journal of Nutrition. 2023 Jan; 129(1): 41-8. doi: 10.1017/S0007114522000071. DOI: https://doi.org/10.1017/S0007114522000071
Reischl-Hajiabadi AT, Garbade SF, Feyh P, Weiss KH, Mütze U, Kölker S et al. Maternal Vitamin B12 Deficiency Detected by Newborn Screening—Evaluation of Causes and Characteristics. Nutrients. 2022 Sep; 14(18): 3767. doi: 10.3390/nu14183767. DOI: https://doi.org/10.3390/nu14183767
St-Cyr C. Derivation of pediatric reference intervals for vitamin B-12 biomarkers and comparison of their diagnostic ability in children at risk of vitamin B-12 deficiency (Doctoral dissertation, University of British Columbia). 2021.
Bakken KS, Kvestad I, Bjørkevoll SM, Solvik BS, Kaldenbach S, McCann A et al. Vitamin B12 Status in Infancy and the Effect of a Vitamin B12 Injection in Infants with Subclinical Vitamin B12 Deficiency: Study Protocol for A Register-Based Randomised Controlled Trial. British Medical Journal Open. 2023 Apr; 13(4): e069102. doi: 10.1136/bmjopen-2022-069102. DOI: https://doi.org/10.1136/bmjopen-2022-069102
Garzone EO and Zanella PB. The importance of Vitamin B12 for Neurological and Cognitive Function: from Pregnancy to Childhood. Revista de Atenção à Saúde. 2021; 19(69): 339-50.
Sugapradha GR, Holla R, Manjrekar P, Rao S. Association of Maternal and Cord Vitamin B12 Levels with Anthropometry in Term Neonates Born to Malnourished Mothers in Coastal South India. F1000Research. 2024 Jul; 13: 530. doi: 10.12688/f1000research.150696.1. DOI: https://doi.org/10.12688/f1000research.150696.1
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