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Maternal vitamin B12 status in pregnancy and cognitive function in 9-year-old Indian children. (Pune Maternal Nutritonal Study – Decile)


Funded By:  Diabetes Unit, KEM Hospital - Pune
Month and Year of Commencement:  July 2005
Current Status:  Completed

Principal Investigator:  Dr. C.S.Yajnik,Director,Diabetes Unit, KEM Hospital and Research Centre,Pune,India
Co-Investigator: Prof.CHDFall ,Professor of International Paediatric Epidemiology, Southampton General Hospital ,UK




        
» Background
» Objectives
» Methodology and Design
» Results



Background

Lack of vitamin B12 may affect brain structure and functions at different stages of life.

Objectives

To investigate relationship between maternal vitamin B12 status during pregnancy with the neuro-cognitive functioning in offspring during childhood.


Methodology and Design

We designed a nested case control study from the PMNS to investigate the association between maternal vitamin B12 status in pregnancy and offspring cognitive function. We compared the neuro-cognitive function in the children born to mothers who had low vitamin B12 concentration in pregnancy (cases) with that of children whose mothers had high vitamin B12 concentration (controls). Low and high vitamin B12 concentration referred to lowest (<77pmol/L) and highest (>224 pmol/L) deciles of maternal plasma vitamin B12 concentration at 28 weeks gestation.



Results

Total 108 children were studied. Cases performed slower on the Colour Trail A Test, and digit span backword test compared to controls (p<0.05). This difference remained significant after adjusting for age and gender of the child, family's socio-economic status, and child's plasma vitamin B12 concentration at 6years of age. The performance of the cases and controls on other tests was similar 90% of children performed below the reference median for Colour Trail Test.

Performance for other tests was comparable to the reference scores. Head circumference of the child at the time of testing as well as at birth were directly and independently predictive of the performance for CPM, visual recognition and digit span tests.

Vitamin B12 deficiency may affect brain structure and functions at different stages of life. We investigated the relation between maternal vitamin B12 status during pregnancy (28 wks gestation) and the cognitive function in 108 children at 9.6y of age in the Pune Maternal Nutritional Study.

Head circumference at birth and at the time of testing were both independent predictors of cognitive performance on a number of tests. Children of mothers with low vitamin B12 concentration (<77 pmol/L) performed slower on the test of attention and memory ( p<0.05 for all) compared to children of mothers with high vitamin B12 concentration (>224 pmol/L). Other tests of cognitive function (intelligence, visual agnosia) did not show significant difference. Our data suggest that maternal vitamin B12 status during pregnancy is an independent determinant of neurocognitive function in Indian children.



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