scholarly journals Can Homocysteine Be Used to Identify Vitamin B12 or Folate Deficiencies During Pregnancy in Low Resource Settings?

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 707-707
Author(s):  
Gayani Amarasinghe ◽  
Imasha Jayasinghe ◽  
Ayesh Hettiarachchi ◽  
Iresha Koralegedara ◽  
Chamila Kappagoda ◽  
...  
Keyword(s):  
Higher Education ◽  
Sri Lanka ◽  
Vitamin B12 ◽  
Pregnant Women ◽  
Folate Deficiency ◽  
Skewed Distribution ◽  
Folate Level ◽  
Predictive Values ◽  
B12 Deficiency

Abstract Objectives With universal iron supplementation during pregnancy, role of other nutritional causes of anemia such as Vitamin B12 and folate deficiencies are increasingly coming to light. Testing vitamin B12 and folate levels is costly and inconvenient in low and middle income settings. Serum Homocysteine level is proposed as a cheaper and more feasible alternative to indicate vitamin B12/folate deficiency. We evaluated the role of Homocysteine as a predictor of B12/folate level among anaemic pregnant women in Sri Lanka. Methods We measured fasting serum total Homocysteine in a randomly selected sub sample of anaemic pregnant women (hemoglobin less than 11g/dl) from the Rajarata Pregnancy Cohort (RaPCo), Anuradhapura, Sri Lanka. They were referred to a special hospital clinic for B12 and folate assessment within 2 weeks of the initial assessment. Homocysteine levels > 6.9 µmol/L in first and > 9.6 µmol/L in second trimesters were defined as Hyperhomocysteinaemia. B12 levels below 203 pg/ml and folate levels below 4ng/ml were defined as deficiency. Sensitivity and specificity were calculated and Spearmen correlation was performed. Results Twenty two anaemic pregnant women in 6 to 18 weeks of gestation were included in the assessment. Median haemoglobin level of the selected sample was 10.2 g/dl (Range 8.2–10.9). Homocysteine (Range 4.43–17, median 8 µmol/L), B12 (Range 149.6–721, median 299.8 pg/ml) and folate (Range 5.5–40, median 16.6 ng/ml) showed skewed distribution. Hyperhomocysteinaemia was observed in 12/22 (50%) pregnant women and B12 deficiency was observed in five participants (22.7% CI 10.1–43.4). None had folate deficiency. Hyperhomocysteinaemia was present in 2/5 (40%) B12 deficient and 10/17 (58.8%) B12 normal participants. Sensitivity of Homocysteine to indicate B12 deficiency was 40% (95% CI 11.8 to 76.9) and specificity was 41.2% (21.6, 67). Predictive values of positive and negative tests were 16.7% and 70% respectively. Homocysteine levels did not correlate with B12 level (Spearmen r = -0.26, p = 0.24) or folate level (spearmen r = 0.04, p = 0.86). Conclusions Elevated Homocysteine levels cannot be used as a reliable indicator of B12 or Folate deficiency in anaemic pregnant women. Funding Sources Accelerating Higher Education Expansion and Development (AHEAD) Operation of the Ministry of Higher Education, Sri Lanka.

scholarly journals The effect of folate analogues and vitamin B12 on provision of thymine nucleotides for DNA synthesis in megaloblastic anemia

Blood ◽  
1982 ◽  
Vol 59 (3) ◽  
pp. 634-640
Author(s):  
MR Taheri ◽  
RG Wickremasinghe ◽  
BF Jackson ◽  
AV Hoffbrand
Keyword(s):  
Vitamin B12 ◽  
De Novo ◽  
Megaloblastic Anemia ◽  
Vitamin B12 Deficiency ◽  
Folate Deficiency ◽  
Minor Role ◽  
B12 Deficiency ◽  
Thymidylate Synthesis ◽  
Marrow Cells

The role of vitamin B12 in the folate dependent biosynthesis of thymidine nucleotides is controversial. In an attempt to clarify this, three methods have been used to assess the relative efficacy of vitamin B12 (hydroxocobalamin) and various folate analogues in titrated concentrations at correcting ‘de novo’ thymidylate synthesis by megaloblastic human marrow cells: (1) The deoxyuridine (dU) suppression test which analyses the reduction in (3H)-thymidine labeling of DNA by unlabeled dU. Marrow cells were also labeled with (6–3H)-dU with assessment of (2) its incorporation into DNA and (3) the accumulation of (6–3H)-deoxyuridine monophosphate (3H-dUMP). The three methods gave similar results. In both, N6-formyl tetrahydrofolate (formyl-FH4) was the most effective agent at correcting thymidylate synthesis in megaloblastic anemia due to vitamin B12 or folate deficiency. Vitamin B12 corrected the lesion in vitamin B12 deficiency but not in folate deficiency. Tetrahydrofolate (FH4) and folic acid were effective in deficiency of vitamin B12 or folate, although in both deficiencies they were less effective than formyl-FH4. Methyl-FH4 was effective in folate deficiency but not in vitamin B12 deficiency. These results confirm the failure of methyl-FH4 utilisation in vitamin B12 deficiency. They suggest that if vitamin B12 is needed in the formylation of FH4, this is a minor role in provision of the correct coenzyme for thymidylate synthesis compared with its major role of provision of FH4 from methyl- FH4.

scholarly journals The effect of folate analogues and vitamin B12 on provision of thymine nucleotides for DNA synthesis in megaloblastic anemia

Blood ◽  
1982 ◽  
Vol 59 (3) ◽  
pp. 634-640 ◽  
Author(s):  
MR Taheri ◽  
RG Wickremasinghe ◽  
BF Jackson ◽  
AV Hoffbrand
Keyword(s):  
Vitamin B12 ◽  
De Novo ◽  
Megaloblastic Anemia ◽  
Vitamin B12 Deficiency ◽  
Folate Deficiency ◽  
Minor Role ◽  
B12 Deficiency ◽  
Thymidylate Synthesis ◽  
Marrow Cells

Abstract The role of vitamin B12 in the folate dependent biosynthesis of thymidine nucleotides is controversial. In an attempt to clarify this, three methods have been used to assess the relative efficacy of vitamin B12 (hydroxocobalamin) and various folate analogues in titrated concentrations at correcting ‘de novo’ thymidylate synthesis by megaloblastic human marrow cells: (1) The deoxyuridine (dU) suppression test which analyses the reduction in (3H)-thymidine labeling of DNA by unlabeled dU. Marrow cells were also labeled with (6–3H)-dU with assessment of (2) its incorporation into DNA and (3) the accumulation of (6–3H)-deoxyuridine monophosphate (3H-dUMP). The three methods gave similar results. In both, N6-formyl tetrahydrofolate (formyl-FH4) was the most effective agent at correcting thymidylate synthesis in megaloblastic anemia due to vitamin B12 or folate deficiency. Vitamin B12 corrected the lesion in vitamin B12 deficiency but not in folate deficiency. Tetrahydrofolate (FH4) and folic acid were effective in deficiency of vitamin B12 or folate, although in both deficiencies they were less effective than formyl-FH4. Methyl-FH4 was effective in folate deficiency but not in vitamin B12 deficiency. These results confirm the failure of methyl-FH4 utilisation in vitamin B12 deficiency. They suggest that if vitamin B12 is needed in the formylation of FH4, this is a minor role in provision of the correct coenzyme for thymidylate synthesis compared with its major role of provision of FH4 from methyl- FH4.

scholarly journals The prevalence of low serum levels of Vitamin D, Vitamin B12, folate and ferritin in adolescents: Single center experience

2021 ◽  
Vol 104 (2) ◽  
pp. 003685042110076
Author(s):  
Nazmi Mutlu Karakaş
Keyword(s):  
Vitamin D ◽  
Vitamin B12 ◽  
Medical Records ◽  
Vitamin B12 Deficiency ◽  
Serum Levels ◽  
Folate Deficiency ◽  
Well Child Care ◽  
Single Center Experience ◽  
B12 Deficiency ◽  
Prevalence Of Anemia

Background: In this study, the aim was to evaluate the prevalence of vitamin D, vitamin B12, ferritin, and folate deficiencies in adolescence to clarify the need for early diagnosis and therapy. Methods: The medical records of adolescents between 10 and 18 years of age between 01 September 2018 and 28 February 2019 as healthy with non-specific complaints, or due to well-child care visits, were analyzed retrospectively. Results: A total of 1847/2507 (73.6%) adolescents were included in the study. The prevalence of vitamin D deficiency was 25.7% (n: 178/691). Vitamin B12 deficiency prevalence was 69.2% (n: 753/1088). The prevalence of anemia and ferritin deficiency was 4.8% and 13.26%. The prevalence of folate deficiency was 37.9% (n: 413/1088). VDD prevalence was statistically significantly higher in females than males (F/M:116/62). VB12D prevalence, the number and mean age of females with hemoglobin deficiency, and low ferritin levels was found to be statistically significantly higher in females than males. Conclusions: The prevalence of vitamin D, vitamin B12, folate deficiency and low ferritin levels was found to be high among adolescents. In particular, adolescents admitting with non-specific complaints and for control purposes in big cities must be considered to be at risk for the deficiency of these vitamins and low level of ferritin.

Frequency of Vitamin B12 Deficiency in Pregnant Women with Gestational Diabetes Mellitus

2021 ◽  
Vol 15 (10) ◽  
pp. 2753-2755
Author(s):  
Shazia Jamil ◽  
Naveed Mahmood ◽  
Israr-ul- Haque ◽  
Rabiah Haque ◽  
Muhammad Imran-ul-Hasan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Vitamin B12 ◽  
Pregnant Women ◽  
Vitamin B12 Deficiency ◽  
Group I ◽  
B12 Deficiency ◽  
Vitamin B 12 ◽  
Group Ii

Objective: To determine the prevalence of vitamin B-12 deficiency in pregnant women with gestational diabetes mellitus. Study Design: Retrospective study Place and Duration of Study: Department of Medicine, OMC Hospital, Jail Road Lahore from January, 2020 to December, 2020. Methods: Two hundred and thirty pregnant females were enrolled age between 18-45 years. Detailed demographics of enrolled cases age, gestational age, gravidity and body mass index were recorded after taking informed written consent. Among 230 cases, 100 women were non GDM (group I) and 130 had gestational diabetes mellitus (group II). Blood samples were taken from all the patients for measuring vitamin B12 status. Vitamin B12 was defined as <300 pg/ml. Results: Mean age of the patients in group I was 31.64±7.45 years with mean BMI 25.88±8.65 kg/m2 while mean age among GDM group was 34.55±5.71 years with mean BMI 27.36±9.44 kg/m2. Mean gestational age in group I was 33.72±4.21 weeks and in group II 35.08±9.27 weeks. In group I 20 (20%) had vitamin B12 deficiency and in group II rate ofvitamin B12 deficiency was high among 90 (69.2%) cases. We found a significantly relation between vitamin B12 and GDM with p value <0.0007. Conclusion: The prevalence of vitamin B-12 deficiency among pregnant women of gestational diabetes mellitus was significantly high as compared to normal pregnant women. Keywords: Pregnant Women, Gestational Diabetes Mellitus, Vitamin B12 deficiency

RELATIONSHIP OF MATERNAL VITAMIN B12 STATUS IN PREGNANCY WITH PRETERM BIRTH AND MATERNAL HEALTH RISKS

2020 ◽  
pp. 32-38
Author(s):  
VICTORIA LAZAROVA SPASOVA ◽  
LILIA IVANOVA KOLEVA ◽  
MARIETA ANTONOVA POPOVA ◽  
VALENTINA BOYANOVA PETKOVA ◽  
MILEN VENTZISLAVOV DIMITROV
Keyword(s):  
Preterm Birth ◽  
Vitamin B12 ◽  
Pregnant Women ◽  
Serum Vitamin ◽  
Vitamin B12 Deficiency ◽  
Inverse Association ◽  
Maternal Vitamin ◽  
B12 Deficiency ◽  
The Impact ◽  
In Pregnancy

Vitamin B12 is known to be vital for cell growth and population during pregnancy. This retrospective and prospective case−control study was aimed to disclose a health risk for pregnant women with vitamin B12 deficiency, as well as the one of the preterm birth. The main tasks set and performed in this research were as follows: to compare the obstetrics anamnesis between the women who gave birth on term and women who gave birth before term; to find the prevalence of vitamin B12 insufficiency in pregnancy; to determine its association with preterm birth and low birth weight; to examine its association with spontaneous abortions, and to investigate its relationship with obesity and hemoglobin levels in pregnant women. The conducted investigation involved 107 women who gave birth before the 37th week of gestation and 101 women who gave birth after the 37th week of gestation at the outpatient clinic of the University Hospital "Maichin Dom" in Bulgaria. Our study revealed a correlation between maternal vitamin B12 deficiency, overweight and low hemoglobin level. Our results showed no significant correlation between serum vitamin B12 level and the risk of preterm birth. However, we found an inverse association between vitamin B12 level and overweight before pregnancy and at the time of giving birth. As well there was confirmed the strong connection between meat consumption and vitamin B12 level. The paper emphasizes that the deficiency of the vitamin occurs most likely in the women with inadequate diets. Such a deficiency is actually confirmed to have serious health consequences for pregnant women and their offspring. Therefore further profound and numerous studies should be performed to properly assess the correlation between vitamin B12 and preterm birth, as well as to understand better the impact of vitamin B12 over pregnant women. Key words: vitamin B12, preterm birth, pregnancy, overweight, hemoglobin.

Vitamin B12 deficiency: Is it underestimated in pregnant women?

2006 ◽  
Vol 85 (2) ◽  
pp. 241-242 ◽  
Author(s):  
Robert H. Glew ◽  
Denis M. McCarthy ◽  
Dorothy J. Vanderjagt
Keyword(s):  
Vitamin B12 ◽  
Pregnant Women ◽  
Vitamin B12 Deficiency ◽  
B12 Deficiency

scholarly journals Role of PCR in Rapid Detection Group B Streptococcus in Pregnant Females in Al-Quwayiyah General Hospital, Riyadh, Saudi Arabia

2021 ◽  
pp. 45-52
Author(s):  
E. S. Khater ◽  
A. S. Abdel-Motaal
Keyword(s):  
Saudi Arabia ◽  
Pregnant Women ◽  
General Hospital ◽  
Antimicrobial Susceptibility ◽  
Gestational Age ◽  
Group B Streptococcus ◽  
Predictive Values ◽  
Pregnant Females ◽  
Group B

Background: Group B streptococcus is one of the most common causes of severe neonatal infections. Aim: To detect the prevalence of group B. Streptococcus and their antimicrobial susceptibility and to assess the role of PCR as a rapid method of its detection. Place and Duration of the Study: A cross sectional and prospective cohort study was carried out from September 2019 to February 2020 in Gynaecology and Obstetrics OPD and inpatient units in Al- Quwayiyah General hospital, Riyadh, Saudi Arabia Methodology: Paired rectal/vaginal specimens were collected from 540 pregnant females with gestational age 35 or more, Each swab was inoculated into selective medium, Todd Hewitt, One swab is streaked onto blood agar plates incubated in 5% CO2 for 24h at 36ºC. β-hemolytic colonies growth is identified by Gram’s stain, colony morphology and CAMP test. The confirmation and antimicrobial susceptibility were done by Vitek II machine, The second swab was used for PCR to identify atr gene. Results: Out of 540 pregnant women 87 (16.1%) were colonized with GBS isolates. The positive GBS women aged 25 (22-34) and negative GBS women aged 23 (24-35) with no statistical difference. Patients aged more than 35 years old has the higher rate of positive GBS, 46.2%. No significant association detected between GBS and gestational age at delivery, antenatal visits, BMI and gravidity. The GBS strains isolated from pregnant women was 100% susceptible to linezolid and vancomycin followed by ampicillin (93.1%) and tobramicin (83.9%) then gentamicin (81.6%) and levofloxacin(78.2%) and showed least antibiotic susceptibility to erythromycin (26.4%). The PCR was positive in 145 (26.9%). Using culture as gold method, PCR sensitivity was 100% (95% CI: 91.62-100), while specificity was 83.2% (95% CI: 82.61-91.02). Negative and positive predictive values were 100% and 61% respectively. Kappa between the two methods was 0.71, which indicate major agreement. Conclusion: The GBS prevalence among the pregnant females in Al Quwayiyah General Hospital was 16.1%. Detection of GBS using new PCR technique was found to have high sensitivity and faster results, allowing efficient management of GBS and reduction in newborn morbidity and mortality however the cost is high for some laboratories. Further studies should be assessed to be both low cost and accurate rapid screening.

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