Vitamin B Metabolism and Status during Pregnancy, Lactation and Infancy

Allen, Lindsay H.

doi:10.1007/978-1-4899-2575-6_14

Vitamin B₁₂ Metabolism and Status during Pregnancy, Lactation and Infancy

Lindsay H. Allen³^nAff4

Chapter

351 Accesses
83 Citations

Part of the Advances in Experimental Medicine and Biology book series (AEMB,volume 352)

Abstract

It is generally assumed that vitamin B₁₂ deficiency only occurs during pregnancy and lactation in women who have consumed no animal products for a substantial period of time. However, recently it has emerged that pregnant women who have been strict vegetarians for only a few years, and even omnivores who consume low amounts of animal products, are more likely to become vitamin B₁₂ deficient during pregnancy and lactation, to give birth to an infant who develops clinical or biochemical signs of B₁₂ deficiency, and/or to have low levels of this vitamin in their breast milk. Also, there is recent evidence that vitamin B₁₂ deficiency may be more prevalent in women and infants in some developing countries than formerly appreciated. In view of the potential for vitamin B₁₂ deficiency to cause permanent neurological damage, it is important to understand the relationships between maternal intake and metabolism of vitamin B₁₂ during pregnancy and lactation, and their impact on the mother, fetus, neonate, and secretion of the vitamin in breast milk.

Keywords

Breast Milk
Pernicious Anemia
Megaloblastic Anemia
Breastfed Infant
Corrin Ring

These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

This is a preview of subscription content, access via your institution.

Chapter: USD 29.95; Price excludes VAT (USA)

eBook: USD 149.00; Price excludes VAT (USA)

Softcover Book: USD 199.99; Price excludes VAT (USA)

Hardcover Book: USD 249.99; Price excludes VAT (USA)

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

References

Allen, L. H., Backstrand, J. R., Chavez, A. and Pelto, G. H., 1992, “Functional Implications of Malnutrition. Mexico Project Final Report”, University of Connecticut, Storrs, CT.
Google Scholar
Baker, S. J., Jacob, E., Rajan, K. T., and Swaminathan, S. P., 1962, Vitamin B₁₂ deficiency in pregnancy and the puerperium, Br. Med. J. 1:1658.
PubMed CrossRef CAS Google Scholar
Bartels, P. C., Helleman, P. W., and Soons, J. B. J., 1989, Investigation of red cell size-distribution histograms related to folate, vitamin B₁₂ and iron state in the course of pregnancy, Scand. J. Clin. Lab. Invest. 49:763.
PubMed CrossRef CAS Google Scholar
Bloomfield, F. J., Scott, J. M., Somerville, J. J. F., and Weir, D. G., 1973, Levels in normal, pathological and foetal sera of the three transcobalamins, Irish J. Med. Sci. 142:51.
PubMed CrossRef CAS Google Scholar
Brown, J., Robertson, J., and Gallagher, N., 1977, Humoral regulation of vitamin B₁₂ absorption by pregnant mouse small intestine, Gastroenterology 72:881.
PubMed CAS Google Scholar
Chanarin, I., 1979, “The Megaloblastic Anemias,” Second edition, Blackwell Scientific Publications, London.
Google Scholar
Close, G. C., 1983, Rastafarianism and the Vegans syndrome, Br. Med. J. 286:473.
CrossRef CAS Google Scholar
Cordingley, F. T. and Crawford, G. P. M., 1986, Giardia infection causes vitamin B₁₂ deficiency, Aust N Z. J Med. 16:78.
PubMed CrossRef CAS Google Scholar
Craft, I. L., Matthews, D. M., and Linnell, J. C., 1971, Cobalamins in human pregnancy and lactation J. Clin Path. 24:449.
PubMed CrossRef CAS Google Scholar
Dolphin, B., 1982, “B₁₂. Vol 1, Chemistry; vol. 2, Biochemistry and Medicine,” John Wiley and Sons, New York.
Google Scholar
Donangelo, C. M., Trugo, N. M. F., Koury, J. C., Barreto Silva, M. L, Freitas, L. A., Feldheim, W., and Barth, C., 1989, Iron, zinc, folate and vitamin B₁₂ nutritional status and milk composition of low-income Brazilian mothers, Eur. J. Clin. Nutr. 43:253.
PubMed CAS Google Scholar
Dostálová, L., 1984, Vitamin status in the puerperium and lactation, Ann. Nutr. Metab. 28:385.
PubMed CrossRef Google Scholar
Economides, D. L., Ferguson, J., Mackenzie, I. Z., Darley, J., Ware, I.I., and Holmes-Siedle, M., 1992, Folate and vitamin B₁₂ concentrations in maternal and fetal blood, and amniotic fluid in second trimester pregnancies complicated by neural tube defects, Brit. J. Obstet. Gynecol. 99:23.
CrossRef CAS Google Scholar
Fernandes-Costa, F. and Metz, J., 1979, Transplacental transport in the rabbit of vitamin B₁₂ bound to human transcobalamins I, II and III, Br. J. Haematol. 43:625.
PubMed CrossRef CAS Google Scholar
Fernandes-Costa, F. and Metz, J., 1982, Levels of transcobalamins I, II, and III during pregnancy and in cord blood, Am. J. Clin. Nutr. 35:87.
PubMed CAS Google Scholar
Food and Agriculture Organization, 1988, “Requirements of Vitamin A, Iron, Folate and Vitamin B₁₂. Report of a Joint FAO/WHO Expert Consultation”, FAO, Rome.
Google Scholar
Ford, J. E., 1974, Some observations on the possible nutritional significance of vitamin B₁₂-and folate-binding proteins in milk, Br. J. Nutr. 31:243.
PubMed CrossRef CAS Google Scholar
Fréry, N., Huel, G., Leroy, M., Moreau, T., Savard, R., Blot, P., and Lellouch, J., 1992, Vitamin B₁₂ among parturients and their newborns and its relationship with birthweight, Eur. J. Obstet. Gynecol. Repro. Biol. 45:155.
CrossRef Google Scholar
Friedman, P. A., Shia, M. A., and Wallace, J. K., 1977, A saturable high affinity binding site for transcobalamin II-vitamin B₁₂ complexes in human placental membrane preparations, J. Clin. Invest. 59:51.
PubMed CrossRef CAS Google Scholar
Garewal, G., Narang, A., and Das, K. C., 1988, Infantile tremor syndrome: a vitamin B₁₂ deficiency syndrome in infants, J. Trop. Pediat. 34:174.
CrossRef CAS Google Scholar
Gimsing, P. and Nexo, E., 1983, The forms of cobalamin in biological materials, in “The cobalamins”, C. A. Hall, ed., Churchill-Livingstone, New York.
Google Scholar
Giugliani, E. R. J., Jorge, S. M., and Goncalves, A. L., 1985, Serum vitamin B₁₂ levels in parturients, in the inter-villous space of the placenta, and in full-term newborns and their interrelationships with folate levels, Am.J. Clin. Nutr. 41:330.
PubMed CAS Google Scholar
Graber, S. E., Scheffel, U., Hodkinson, B., and Mclntyre, P. A., 1971, Placental transport of vitamin B₁₂ in the pregnant rat, J. Clin. Invest. 50:1000.
PubMed CrossRef CAS Google Scholar
Gregory, M. E. and Holdsworth, E. S., 1955, The occurrence of a cyanocobalamin-binding protein in milk and the isolation of a cyanocobalamin-protein complex from sow’s milk, Biochem. J. 59:329.
PubMed CAS Google Scholar
Grossowitz, N., Jablonska, M., and Beyth, Y., 1983, Vitamin B12-binding proteins in human amniotic fluid: an index to fetal maturity, Am. J. Obstet. Gynecol. 146:331.
Google Scholar
Hall, C. A. and Begley, J. A., 1977, Congenital deficiency of human R-type binding proteins of cobalamin, Am. J. Human Genetics. 29:619.
CAS Google Scholar
Heisel, M. A., Siegel, S. E., Falk, R. E., Siegel, M. M., Carmel, R., Lechago, J., Skaff, G., Roessel, T., Nielsen, P. G., and Cummings, P., 1984, Congenital pernicious anemia: Report of seven patients, with studies of the extended family, J. Pediatr. 105:564.
PubMed CrossRef CAS Google Scholar
Hellegers, A., Okuda, K., Nesbitt, R. E. L., Smith, D. W., and Chow, B. F., 1957, Vitamin B₁₂ absorption in pregnancy and in the newborn, Am. J. Clin. Nutr. 5:327.
PubMed CAS Google Scholar
Herbert, V., Colman, N., Spivack, M. et al., 1975, Folic acid deficiency in the United States: folate assays in a prenatal clinic, Am. J. Obstet. Gynecol 123:175.
PubMed CAS Google Scholar
Herbert, V., Manusselis, C., Drivas, G., and Colman, N., 1983, Low vitamin B₁₂ content of heavily processed milks may explain vitamin B₁₂ deficiency in young adults in Mexico, Clin. Res. 31:241 A.
Google Scholar
Herbert, V., 1987a, The 1986 Herman Award Lecture, Nutrition science as a continually unfolding story: the folate and vitamin B-12 paradigm, Am. J. Clin. Nutr. 46:387.
PubMed CAS Google Scholar
Herbert, V., 1987b, Recommended dietary intakes (RDI) of vitamin B-12 in humans, Am. J. Clin. Nutr. 45:671.
PubMed CAS Google Scholar
Herbert, V., 1990a, Vitamin B-12, in “Present Knowledge in Nutrition,” International Life Sciences Institute-Nutrition Foundation, Washington D. C.
Google Scholar
Herbert, V., Fong, W., Guile, V., and Stopler, T., 1990b, Low holotranscobalamin II is the earliest serum marker for subnormal vitamin B₁₂ (cobalamin) absorption in patients with AIDS, Am. J. Hemat. 34:132.
PubMed CrossRef CAS Google Scholar
Hitzig, W. H., Dohmann, V., Pluss, H. J., and Vischer, D., 1974, Hereditary transcobalamin II deficiency: clinical findings in a family, J. Pediatr. 85:622.
PubMed CrossRef CAS Google Scholar
Hoey, H., Linnell, J. C., Oberholzer, V. G., and Laurance, B. M., 1982, Vitamin B₁₂ deficiency in a breastfed infant with pernicious anemia, J. Roy. Soc. Med. 75:656.
PubMed CAS Google Scholar
Immerman, A. M., 1981, Vitamin B₁₂ status on a vegetarian diet, World. Rev. Nutr. Diet. 37:38.
PubMed CAS Google Scholar
Institute of Medicine., 1990, “Nutrition During Pregnancy,” National Academy Press, Washington D. C.
Google Scholar
Institute of Medicine., 1991, “Nutrition During Lactation,” National Academy Press, Washington D. C.
Google Scholar
Jadhav, M., Webb, J. K. G., Vaishnava, S., and Baker, S. J., 1962, Vitamin B₁₂ deficiency in Indian infants: a clinical syndrome, Lancet ii:903.
CrossRef Google Scholar
Johnson, P. R. and Roloff, J. S., 1982, Vitamin B12 deficiency in an infant strictly breast-fed by a mother with pernicious anemia, J. Pediatr. 100:917.
PubMed CrossRef Google Scholar
Kanazawa, S., Herbert, V., Herzlicj, B., Drivas, G., and Manusselis, C., 1983, Removal of cobalamin analogues in bile by enterohepatic circulation of vitamin B₁₂, Lancet i:707.
CrossRef Google Scholar
Kaul, K. K., Prasan, N., and Chowdhury, R. M., 1963, Some clinical observations and impressions on a syndrome of tremors in infants from India, J. Pediat. 63:1158.
PubMed CrossRef CAS Google Scholar
Kolhouse, J. F., Kondo, H., Allen, N. C., Pdell, E., and Allen, R. H., 1978, Cobalamin analogues are present in human plasma and can mask cobalamin deficiency because current radioisotope-dilution assays are not specific for true cobalamin, N. Engl. J. Med. 299:785.
PubMed CrossRef CAS Google Scholar
Kumento, A., 1969, Studies on the serum binding of vitamin B₁₂ in the newborn human infant, Acta Paediatr. Scand. 194:1.
Google Scholar
Lampkin, B. D., Shore, N. A., and Chadwick, D., 1966, Megaloblastic anemia of infancy secondary to maternal pernicious anemia, N. Engl. J. Med. 274, 1168.
PubMed CrossRef CAS Google Scholar
Luhby, A. L., Cooperman, J. M., Donnfield, A. M. et al., 1958, Observations on the transfer of vitamin B-12 from mother to fetus and newborn, Am. J. Dis. Child 96:532.
Google Scholar
Luhby, A. L., Cooperman, J. M., Stone, M. L. et al., 1961, Physiology of vitamin B₁₂ in pregnancy, the placenta, and the newborn, Am. J. Dis. Child 102:753.
Google Scholar
McPhee, A. J., Davidson, G. P., Leahy, M., and Beare, T., 1988, Vitamin B₁₂ deficiency in a breast fed infant, Arch. Dis. Childh. 63:921.
PubMed CrossRef CAS Google Scholar
National Research Council, 1989, Vitamin B₁₂, in “Recommended Dietary Allowances”, 10th edition, National Academy Press, Washington D. C.
Google Scholar
Neumann, C., Bwibo, N. O., and Sigman, M., 1992, “Functional Implications of Malnutrition. Kenya Project Final Report,” University of California, Los Angeles, CA.
Google Scholar
Pathak, A., Godwin, H. A., and Prudent, L. M., 1972, Vitamin B₁₂ and folic acid in premature infants, Pediatrics 50:584.
PubMed CAS Google Scholar
Porck, H. J., Frater-Schroder, M., Frants, R. R., Kierat, L., and Eriksson, A. W., 1983, Genetic evidence for fetal origin of transcobalamin II in human cord blood, Blood 62:234.
PubMed CAS Google Scholar
Ramasamy, M., Alpers, D. H., Tiruppathi, C., and Seetharam, B., 1989, Cobalamin release from intrinsic factor and transfer to transcobalamin II within the rat enterocyte, Am. J. Physiol. 257:G791.
PubMed CAS Google Scholar
Rapazzo, M. E., Salmi, H. A., and Hall, C. A., 1970, The content of vitamin B₁₂ in adult and foetal tissue: A comparative study, Br. J. Haematol. 18:425.
CrossRef Google Scholar
Roberts, P. D., James, H., Petrie, A., Morgan, J. O., and Hoffbrand, A. V., 1973, Vitamin B₁₂ status in pregnancy among immigrants to Britain, Br. Med. J. 3:67.
PubMed CrossRef CAS Google Scholar
Robertson, J. A. and Gallagher, N. D., 1983, Increased intestinal uptake of cobalamin in pregnancy does not require synthesis of new receptors, Biochim. Biophys. Acta. 757:145.
PubMed CrossRef CAS Google Scholar
Rosenblatt, D. S. and Cooper, B. A., 1987, Inherited disorders of vitamin B₁₂ metabolism, Blood Reviews, 1:177.
PubMed CrossRef CAS Google Scholar
Sadowitz, P. D., Livingston, A., and Cavanaugh, R. M., 1986, Developmental regression as an early manifestation of vitamin B₁₂ deficiency, Clin. Pediatr. 25:369.
CrossRef CAS Google Scholar
Sandberg, D. P., Begely, J. A., and Hall, C. A., 1981, The content, binding, and forms of vitamin B₁₂ in milk, Am.J. Clin. Nutr. 34:1717.
PubMed CAS Google Scholar
Schwartz, M. and Weber, J., 1971, Gastric intrinsic factor in human foetus, Scand. J. Gastroent. 9:suppl. 29:57.
CAS Google Scholar
Seligman, P. A. and Allen, R. H., 1978, Characterization of the receptor for transcobalamin II isolated from human placenta, J. Biol. Chem. 253:1766.
PubMed CAS Google Scholar
Sneed, S. S., Zane, C., and Thomas, M. R., 1981, The effects of ascorbic acid, vitamin B₆ vitamin B₁₂, and folic acid supplementation on the breast milk and maternal nutritional status of low socioeconomic lactating women, Am. J. Clin. Nutr. 34:1338.
PubMed CAS Google Scholar
Specker, B. L., Miller, D., Norman, E. J., Greene, H., and Hayes, K. C., 1988, Increased urinary methylmalonic acid excretion in breast-fed infants of vegetarian mothers and identification of an acceptable dietary source of vitamin B-12, Am. J. Clin. Nutr. 47:89.
PubMed CAS Google Scholar
Specker, B. L., Black, A., Allen, L., and Morrow, F., 1990a, Vitamin B-12: low milk concentrations are related to low serum concentrations in vegetarian women and to methylmalonic aciduria in their infants, Am. J. Clin. Nutr. 52:1073.
PubMed CAS Google Scholar
Specker, B. L., Brazerol, W., Ho, M. L., and Norman, E. J., 1990b, Urinary methylmalonic acid excretion in infants fed formula or human milk, Am. J. Clin. Nutr. 51:209.
PubMed CAS Google Scholar
Srikantia, S. G. and Reddy, V., 1967, Megaloblastic anemia of infancy and vitamin B₁₂, Br. J. Haemat. 13:949.
CrossRef CAS Google Scholar
Suter, P. M., Golner, B. B., Goldin, B. R., Morrow, F. D., and Russell, R. M., 1991, Reversal of protein-bound vitamin B₁₂ malabsorption with antibiotics in atrophic gastritis, Gastroenterology 101:1039.
PubMed CAS Google Scholar
Thomas, M. R., Sneed, S. M., Wei, C., Nail, P. A., Wilson, M., and Sprinkle, E. E., 1980, The effects of vitamin C., vitamin B₆, vitamin B₁₂, folic acid, riboflavin and thiamin on the breast milk and maternal status of well-nourished women at 6 months postpartum, Am. J. Clin. Nutr. 33:2151.
PubMed CAS Google Scholar
Trugo, N. M. F., 1992, Vitamin Bj2 absorption in the neonatal period, in “Mechanisms Regulating Lactation and Infant Nutrient Utilization”. M. F. Picciano and B. Lonnerdal, eds. New York, Wiley-Liss.
Google Scholar

Download references

Author information

Lindsay H. Allen
Present address: Department of Nutrition, University of California, Davis, CA, 95616-8669, USA

Authors and Affiliations

Department of Nutritional Sciences, University of Connecticut, Storrs, CT, 06269-4017, USA
Lindsay H. Allen

Authors

Lindsay H. Allen
View author publications
You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

University of California-Davis, Davis, California, USA
Lindsay Allen & Bo Lönnerdal &
University of California-Berkeley, Berkeley, California, USA
Janet King

Rights and permissions

Reprints and Permissions

Copyright information

About this chapter

Cite this chapter

Allen, L.H. (1994). Vitamin B₁₂ Metabolism and Status during Pregnancy, Lactation and Infancy. In: Allen, L., King, J., Lönnerdal, B. (eds) Nutrient Regulation during Pregnancy, Lactation, and Infant Growth. Advances in Experimental Medicine and Biology, vol 352. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-2575-6_14

Download citation

DOI: https://doi.org/10.1007/978-1-4899-2575-6_14
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4899-2577-0
Online ISBN: 978-1-4899-2575-6
eBook Packages: Springer Book Archive