Research Article
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Şanlıurfa’da Anne ve Yenidoğan Bebeklerinde B12 ve Folik Asit Eksikliğinin Sıklığı

Year 2023, Volume: 20 Issue: 1, 149 - 154, 27.04.2023
https://doi.org/10.35440/hutfd.1254961

Abstract

Amaç: Gebelerde B12 vitamini eksikliği sadece anneleri değil bebeklerini de etkileyen önemli bir sağlık sorunudur. Bu çalışmanın amacı gebelerde ve yeni doğan bebeklerinde B12 vitamini ve folik asit eksikliği sıklığını ortaya koymak, maternal ve neonatal vitamin B12 ile folik asit düzeyleri arasındaki ilişkiyi değerlendirmek ve vitamin B12 eksikliği için risk faktörlerini belirlemektir.
Materyal ve Metod: Bu prospektif çalışmaya Şanlıurfa ilinde kadın doğum polikliniğine başvuran 600 gebe (gebelik yaşı: 38-42 hafta) ve perinatal komplikasyonu olmayan (doğum ağırlığı ≥2500 g) yeni doğan bebekleri dahil edildi. B12 vitamini için alt sınır 200 pg/mL olarak tanımlandı. Tüm annelerde yaş, çocuk sayısı, ilaç kullanımı, yandaş hastalık veya vejeteryan olup olmama ile ilgili veriler kaydedildi.
Bulgular: Dahil edilen gebelerin %73,8'inde B12 vitamini eksikliği, %10,3'ünde folik asit eksikliği saptandı. Yine yeni doğan bebeklerin %70,5'inde B12 vitamini eksikliği, %3,7'sinde folik asit eksikliği tespit edildi. Yenidoğan bebeklerde vitamin B12 düzeylerinin anne düzeyleriyle ilişkili olduğu sonucuna varıldı.
Sonuç: Sonuç olarak Türkiye'deki yenidoğanların önemli bir kısmında B12 vitamini eksikliği olduğu gösterilmiştir. Yakın zamanda doğum yapan annelerde B12 vitamini seviyeleri oldukça düşüktü. Rahim içi dönemde beyin gelişiminde önemli rol oynayan B12 vitamini eksikliği, önlenebilir bir nörolojik defisit nedenidir. Bu nedenle, klinik semptomların ortaya çıkmasından önce B12 vitamini eksikliğinin taranması ve tedavi edilmesi oldukça önemlidir. Çalışmamızın bu açıdan faydalı olduğunu düşünüyoruz.

Supporting Institution

Harran Üniversitesi Tıp Fakültesi Kurumsal Etik Kurulu

Project Number

15/03/18

References

  • 1. Doğan M, Demirci S. Vitamin B12 ve nörolojik hastalıklardaki etkisi. SD Ü Sağlık Bilimleri Enstitüsü Dergisi. 2010;1(1):23-9.
  • 2. Halise A, Polat E, Malbora B, Tuygun N, Karacan CD. Süt Çocukluğu Döneminde Bir Pansitopeni Nedeni: B12 Vitamini Eksikliği. Türkiye Çocuk Hastalıkları Dergisi. 2016;10(1):67-9.
  • 3. Önal H, Adal E, Öner T, Önal Z, Aydın A. Gelişmekte olan ülkelerde önemli bir sorun: annede ve yenidoğanda B12 vi-tamini eksikliği Özgün Araştırma. Türk Pediatri Arşivi. 2010;45(3):42-5.
  • 4. Alter B, Young N, Nathan D, Oski F. Hematology of infancy and childhood. 1998.
  • 5. Hall CA. Function of vitamin B12 in the central nervous sys-tem as revealed by congenital defects. American journal of hematology. 1990;34(2):121-7.
  • 6. Adkins Y, Lönnerdal B. Mechanisms of vitamin B12 absorp-tion in breast-fed infants. Journal of pediatric gastroentero-logy and nutrition. 2002;35(2):192-8.
  • 7. Healton EB, Savage DG, Brust J, Garrett T, Lindenbaum J. Neurologic aspects of cobalamin deficiency. Medicine (Bal-timore). 1991;70(4):229-45.
  • 8. Halicioglu O, Sutcuoglu S, Koc F, Ozturk C, Albudak E, Colak A, et al. Vitamin B12 and folate statuses are associated with diet in pregnant women, but not with anthropometric mea-surements in term newborns. The Journal of Maternal-Fetal & Neonatal Medicine. 2012;25(9):1618-21.
  • 9. İncecik F, Hergüner MÖ, Altunbaşak Ş, Leblebisatan G. Neu-rologic findings of nutritional vitamin B 12 deficiency in child-ren. Turkish Journal of Pediatrics. 2010;52(1).
  • 10. Institute of Medicine Standing Committee on the Scientific Evaluation of Dietary Reference I, its Panel on Folate OBV, Choline. The National Academies Collection: Reports funded by National Institutes of Health. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B(6), Folate, Vitamin B(12), Pantothenic Acid, Biotin, and Choline. Washington (DC): National Academies Press (US) Copyright © 1998, Na-tional Academy of Sciences.; 1998.
  • 11. Toukan Au, Sharaıha Zk, Abu-El-Rub Oa, Hmoud Mk, Dahbour Ss, Abu-Hassan H, et al. The epidemiology of hepa-titis B virus among family members in the Middle East. Ame-rican journal of epidemiology. 1990;132(2):220-32.
  • 12. Bjerner J, Nustad K, Norum LF, Olsen KH, Børmer OP. Im-munometric assay interference: incidence and prevention. Clinical chemistry. 2002;48(4):613-21.
  • 13. Matchar DB, McCrory DC, Millington DS, Feussner JR. Per-formance of the serum cobalamin assay for diagnosis of co-balamin deficiency. The American journal of the medical sci-ences. 1994;308(5):276-83.
  • 14. Lindenbaum J, Savage DG, Stabler SP, Allen RH. Diagnosis of cobalamin deficiency: II. Relative sensitivities of serum coba-lamin, methylmalonic acid, and total homocysteine concent-rations. American journal of hematology. 1990;34(2):99-107.
  • 15. Jadhav M, Webb J, Vaishnava S, Baker S. Vitamin-B12Deficiency in Indian Infants. A Clinical Syndrome. Lancet. 1962:903-7.
  • 16. Allen LH. How common is vitamin B-12 deficiency? The Ame-rican journal of clinical nutrition. 2009;89(2):693S-6S.
  • 17. Smith J, Coman D. Vitamin B12 deficiency: an update for the general paediatrician. Pediat Therapeut. 2014;4(188):2161-0665.1000188.
  • 18. Koc A, Kocyigit A, Soran M, Demir N, Sevinc E, Erel O, et al. High frequency of maternal vitamin B12 deficiency as an im-portant cause of infantile vitamin B12 deficiency in Sanliurfa province of Turkey. European journal of nutrition. 2006;45(5):291-7.
  • 19. Ertaş T. Şanlıurfa'da bebeklik dönemin b12 vitamin eksikliği-nin sıklığı, nedenleri ve b12 vitamini eksikliğinin fiziksel, men-tal ve psikomotor gelişim üzerine etkileri. Tıpta Uzmanlık te-zi. Harran Üniversitesi, Tıp Fakültesi, Urfa; 2004.
  • 20. Guerra-Shinohara EM, Paiva AA, Rondó PcH, Yamasaki K, Terzi CA, D'Almeida V. Relationship between total homocys-teine and folate levels in pregnant women and their newborn babies according to maternal serum levels of vita-min B12. BJOG: an international journal of obstetrics and gynaecology. 2002;109(7):784-91.
  • 21. Monsen A-LB, Ueland PM, Vollset SE, Guttormsen AB, Mar-kestad T, Solheim E, et al. Determinants of cobalamin status in newborns. Pediatrics. 2001;108(3):624-30.
  • 22. Giugliani E, Jorge S, Goncalves A. Serum vitamin B12 levels in parturients, in the intervillous space of the placenta and in full-term newborns and their interrelationships with folate levels. The American journal of clinical nutrition. 1985;41(2):330-5.
  • 23. Sayar EH, Orhaner BB, Sayar E, NesrinTuran F, Küçük M. The frequency of vitamin B12, iron, and folic acid deficiency in the neonatal period and infancy, and the relationship with maternal levels. Turkish Archives of Pediatrics/Türk Pediatri Arşivi. 2020;55(2):139.
  • 24. Schulpis K, Spiropoulos A, Gavrili S, Karikas G, Grigori C, Vlachos G, et al. Maternal–neonatal folate and vitamin B12 serum concentrations in Greeks and in Albanian immigrants. Journal of human nutrition and dietetics. 2004;17(5):443-8.
  • 25. Büyükyazı C, Özkan A, Bahar A, Karademir F, Göçmen İ, Mete Z. Annelerdeki demir eksikliğinin yenidoğanlara etkisi. Türk Hematoloji Onkoloji Dergisi. 1999;9(4):218-21.
  • 26. Akça E, Acar S, Karaali Z. Gebelerdeki aneminin Türkiye’de yöresel dağılımı. Haseki Tıp Bülteni. 2009;47(1):31-5.
  • 27. Eryılmaz G. Erzurum bölgesinde miadındaki gebelerin he-moglobin, serum ferritin değerlerinin bebek hemoglobinin, serum ferritin değerleri ile bebek ve plesanta ağırlıklarına et-kisi. Editör: Y Öztürk, Hemşirelik-Ebelik Eğitim ve Uygulama-larında Kalite Sempozyumu, Kayseri. 1998:235-47.
  • 28. Erdoğan M. Erken gebelik döneminde folik asit, B 12 vitami-ni, ferritin, hemoglobin, magnezyum, çinko değerleri ve obs-tetrik sonuçları (tez). Ankara: Ankara Üniversitesi. 2003.
  • 29. Bratlid D, Moe P. Hemoglobin and serum ferritin levels in mothers and infants at birth. European journal of Pediatrics. 1980;134(2):125-7.
  • 30. Bolaman Z, Kadikoylu G, Yukselen V, Yavasoglu I, Barutca S, Senturk T. Oral versus intramuscular cobalamin treatment in megaloblastic anemia: a single-center, prospective, rando-mized, open-label study. Clinical therapeutics. 2003;25(12):3124-34.
  • 31. Kuzminski AM, Del Giacco EJ, Allen RH, Stabler SP, Linden-baum J. Effective treatment of cobalamin deficiency with oral cobalamin. Blood, The Journal of the American Society of Hematology. 1998;92(4):1191-8.
  • 32. Ackurt, F., Wetherilt, H., Löker, M., & Hacibekiroğlu, M. (1995). Biochemical assessment of nutritional status in pre-and post-natal Turkish women and outcome of pregnancy. European journal of clinical nutrition, 49(8), 613-622.
  • 33. Green, R., Colman, N., & Metz, J. (1975). Comparison of results of microbiologic and radioisotopic assays for serum vitamin B12 during pregnancy. American Journal of Obstet-rics and Gynecology, 122(1), 21-24.
  • 34. Cikot, R. J., Steegers-Theunissen, R. P., Thomas, C. M., de Boo, T. M., Merkus, H. M., & Steegers, E. A. (2001). Longitu-dinal vitamin and homocysteine levels in normal pregnancy. British Journal of Nutrition, 85(1), 49-58.

The Frequency of Vitamin B12 and Folic Acid Deficiency in Mothers and Their Newborn Infants in Şanlıurfa Province

Year 2023, Volume: 20 Issue: 1, 149 - 154, 27.04.2023
https://doi.org/10.35440/hutfd.1254961

Abstract

Background: Vitamin B12 deficiency in pregnant women is an important health issue which not only affects mothers but also their infants. The aim of this study is to reveal the frequency of vitamin B12 and folic acid deficiency in pregnant women and their newborn babies, to evaluate the relationship between maternal and neonatal vitamin B12 and folic acid levels, and to determine the risk factors for vitamin B12 deficiency.
Materials and Methods: This prospective study included 600 pregnant women (gestational age: 38-42 weeks) who presented to obstetrics departments in Şanlıurfa Province and their newborn infants without perinatal complication (birth weight≥2500 g). The lower limit for vitamin B12 was defined as 200 pg/mL. Data regarding age, number of child, medication, comorbid disease or being vegetarian or not were recorded in all mothers.
Results: Vitamin B12 deficiency was found in 73.8% of the included pregnant women, and folic acid deficiency was found in 10.3%. Again, 70.5% of newborn babies were found to have vitamin B12 deficiency and 3.7% to have folic acid deficiency. It was concluded that vitamin B12 levels in newborn babies were related to maternal levels.
Conclusions: As a result, it has been shown that a significant portion of newborns in Turkey have vitamin B12 deficiency. Vitamin B12 levels were quite low in mothers who gave birth recently. The deficiency of vitamin B12, which plays a major role in brain development upon intrauterine period, is a preventable cause of neurological deficit. Thus, it is highly important to screen and treat vitamin B12 deficiency before onset of clinical symptoms. We believe that our study is beneficial in this regard.

Project Number

15/03/18

References

  • 1. Doğan M, Demirci S. Vitamin B12 ve nörolojik hastalıklardaki etkisi. SD Ü Sağlık Bilimleri Enstitüsü Dergisi. 2010;1(1):23-9.
  • 2. Halise A, Polat E, Malbora B, Tuygun N, Karacan CD. Süt Çocukluğu Döneminde Bir Pansitopeni Nedeni: B12 Vitamini Eksikliği. Türkiye Çocuk Hastalıkları Dergisi. 2016;10(1):67-9.
  • 3. Önal H, Adal E, Öner T, Önal Z, Aydın A. Gelişmekte olan ülkelerde önemli bir sorun: annede ve yenidoğanda B12 vi-tamini eksikliği Özgün Araştırma. Türk Pediatri Arşivi. 2010;45(3):42-5.
  • 4. Alter B, Young N, Nathan D, Oski F. Hematology of infancy and childhood. 1998.
  • 5. Hall CA. Function of vitamin B12 in the central nervous sys-tem as revealed by congenital defects. American journal of hematology. 1990;34(2):121-7.
  • 6. Adkins Y, Lönnerdal B. Mechanisms of vitamin B12 absorp-tion in breast-fed infants. Journal of pediatric gastroentero-logy and nutrition. 2002;35(2):192-8.
  • 7. Healton EB, Savage DG, Brust J, Garrett T, Lindenbaum J. Neurologic aspects of cobalamin deficiency. Medicine (Bal-timore). 1991;70(4):229-45.
  • 8. Halicioglu O, Sutcuoglu S, Koc F, Ozturk C, Albudak E, Colak A, et al. Vitamin B12 and folate statuses are associated with diet in pregnant women, but not with anthropometric mea-surements in term newborns. The Journal of Maternal-Fetal & Neonatal Medicine. 2012;25(9):1618-21.
  • 9. İncecik F, Hergüner MÖ, Altunbaşak Ş, Leblebisatan G. Neu-rologic findings of nutritional vitamin B 12 deficiency in child-ren. Turkish Journal of Pediatrics. 2010;52(1).
  • 10. Institute of Medicine Standing Committee on the Scientific Evaluation of Dietary Reference I, its Panel on Folate OBV, Choline. The National Academies Collection: Reports funded by National Institutes of Health. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B(6), Folate, Vitamin B(12), Pantothenic Acid, Biotin, and Choline. Washington (DC): National Academies Press (US) Copyright © 1998, Na-tional Academy of Sciences.; 1998.
  • 11. Toukan Au, Sharaıha Zk, Abu-El-Rub Oa, Hmoud Mk, Dahbour Ss, Abu-Hassan H, et al. The epidemiology of hepa-titis B virus among family members in the Middle East. Ame-rican journal of epidemiology. 1990;132(2):220-32.
  • 12. Bjerner J, Nustad K, Norum LF, Olsen KH, Børmer OP. Im-munometric assay interference: incidence and prevention. Clinical chemistry. 2002;48(4):613-21.
  • 13. Matchar DB, McCrory DC, Millington DS, Feussner JR. Per-formance of the serum cobalamin assay for diagnosis of co-balamin deficiency. The American journal of the medical sci-ences. 1994;308(5):276-83.
  • 14. Lindenbaum J, Savage DG, Stabler SP, Allen RH. Diagnosis of cobalamin deficiency: II. Relative sensitivities of serum coba-lamin, methylmalonic acid, and total homocysteine concent-rations. American journal of hematology. 1990;34(2):99-107.
  • 15. Jadhav M, Webb J, Vaishnava S, Baker S. Vitamin-B12Deficiency in Indian Infants. A Clinical Syndrome. Lancet. 1962:903-7.
  • 16. Allen LH. How common is vitamin B-12 deficiency? The Ame-rican journal of clinical nutrition. 2009;89(2):693S-6S.
  • 17. Smith J, Coman D. Vitamin B12 deficiency: an update for the general paediatrician. Pediat Therapeut. 2014;4(188):2161-0665.1000188.
  • 18. Koc A, Kocyigit A, Soran M, Demir N, Sevinc E, Erel O, et al. High frequency of maternal vitamin B12 deficiency as an im-portant cause of infantile vitamin B12 deficiency in Sanliurfa province of Turkey. European journal of nutrition. 2006;45(5):291-7.
  • 19. Ertaş T. Şanlıurfa'da bebeklik dönemin b12 vitamin eksikliği-nin sıklığı, nedenleri ve b12 vitamini eksikliğinin fiziksel, men-tal ve psikomotor gelişim üzerine etkileri. Tıpta Uzmanlık te-zi. Harran Üniversitesi, Tıp Fakültesi, Urfa; 2004.
  • 20. Guerra-Shinohara EM, Paiva AA, Rondó PcH, Yamasaki K, Terzi CA, D'Almeida V. Relationship between total homocys-teine and folate levels in pregnant women and their newborn babies according to maternal serum levels of vita-min B12. BJOG: an international journal of obstetrics and gynaecology. 2002;109(7):784-91.
  • 21. Monsen A-LB, Ueland PM, Vollset SE, Guttormsen AB, Mar-kestad T, Solheim E, et al. Determinants of cobalamin status in newborns. Pediatrics. 2001;108(3):624-30.
  • 22. Giugliani E, Jorge S, Goncalves A. Serum vitamin B12 levels in parturients, in the intervillous space of the placenta and in full-term newborns and their interrelationships with folate levels. The American journal of clinical nutrition. 1985;41(2):330-5.
  • 23. Sayar EH, Orhaner BB, Sayar E, NesrinTuran F, Küçük M. The frequency of vitamin B12, iron, and folic acid deficiency in the neonatal period and infancy, and the relationship with maternal levels. Turkish Archives of Pediatrics/Türk Pediatri Arşivi. 2020;55(2):139.
  • 24. Schulpis K, Spiropoulos A, Gavrili S, Karikas G, Grigori C, Vlachos G, et al. Maternal–neonatal folate and vitamin B12 serum concentrations in Greeks and in Albanian immigrants. Journal of human nutrition and dietetics. 2004;17(5):443-8.
  • 25. Büyükyazı C, Özkan A, Bahar A, Karademir F, Göçmen İ, Mete Z. Annelerdeki demir eksikliğinin yenidoğanlara etkisi. Türk Hematoloji Onkoloji Dergisi. 1999;9(4):218-21.
  • 26. Akça E, Acar S, Karaali Z. Gebelerdeki aneminin Türkiye’de yöresel dağılımı. Haseki Tıp Bülteni. 2009;47(1):31-5.
  • 27. Eryılmaz G. Erzurum bölgesinde miadındaki gebelerin he-moglobin, serum ferritin değerlerinin bebek hemoglobinin, serum ferritin değerleri ile bebek ve plesanta ağırlıklarına et-kisi. Editör: Y Öztürk, Hemşirelik-Ebelik Eğitim ve Uygulama-larında Kalite Sempozyumu, Kayseri. 1998:235-47.
  • 28. Erdoğan M. Erken gebelik döneminde folik asit, B 12 vitami-ni, ferritin, hemoglobin, magnezyum, çinko değerleri ve obs-tetrik sonuçları (tez). Ankara: Ankara Üniversitesi. 2003.
  • 29. Bratlid D, Moe P. Hemoglobin and serum ferritin levels in mothers and infants at birth. European journal of Pediatrics. 1980;134(2):125-7.
  • 30. Bolaman Z, Kadikoylu G, Yukselen V, Yavasoglu I, Barutca S, Senturk T. Oral versus intramuscular cobalamin treatment in megaloblastic anemia: a single-center, prospective, rando-mized, open-label study. Clinical therapeutics. 2003;25(12):3124-34.
  • 31. Kuzminski AM, Del Giacco EJ, Allen RH, Stabler SP, Linden-baum J. Effective treatment of cobalamin deficiency with oral cobalamin. Blood, The Journal of the American Society of Hematology. 1998;92(4):1191-8.
  • 32. Ackurt, F., Wetherilt, H., Löker, M., & Hacibekiroğlu, M. (1995). Biochemical assessment of nutritional status in pre-and post-natal Turkish women and outcome of pregnancy. European journal of clinical nutrition, 49(8), 613-622.
  • 33. Green, R., Colman, N., & Metz, J. (1975). Comparison of results of microbiologic and radioisotopic assays for serum vitamin B12 during pregnancy. American Journal of Obstet-rics and Gynecology, 122(1), 21-24.
  • 34. Cikot, R. J., Steegers-Theunissen, R. P., Thomas, C. M., de Boo, T. M., Merkus, H. M., & Steegers, E. A. (2001). Longitu-dinal vitamin and homocysteine levels in normal pregnancy. British Journal of Nutrition, 85(1), 49-58.
There are 34 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Article
Authors

Nurgül Ataş 0000-0002-7230-0497

Alpay Cakmak 0000-0002-8830-007X

Project Number 15/03/18
Early Pub Date April 27, 2023
Publication Date April 27, 2023
Submission Date February 24, 2023
Acceptance Date March 29, 2023
Published in Issue Year 2023 Volume: 20 Issue: 1

Cite

Vancouver Ataş N, Cakmak A. The Frequency of Vitamin B12 and Folic Acid Deficiency in Mothers and Their Newborn Infants in Şanlıurfa Province. Harran Üniversitesi Tıp Fakültesi Dergisi. 2023;20(1):149-54.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty