vitamin-b-12 and Stillbirth

Vitamin B12 deficiency during pregnancy and lactation may negatively affect fetal growth, brain development, pregnancy outcome, and breastmilk vitamin B12 content.. To examine associations between pregnant and lactating women's vitamin B12 intake and pregnancy outcomes, breastmilk vitamin B12 concentration, and growth and development of breastfed infants from birth to 6 months.. One hundred thirty-eight Kenyan women were followed during pregnancy, with 98 followed through 6 months of lactation and providing 294 randomly collected breastmilk samples. Maternal hematologic analyses were performed for erythrocyte morphology, erythrocyte size, and serum vitamin B12 concentration. Women's and infants'food intake was assessed. Breastmilk vitamin B12 was measured by a competitive binding isotope dilution technique. Infant anthropometric data and the Brazelton Neonatal Behavioral Assessment Scale (BNBAS) were assessed within 3 days after birth. The Infant Bayley Motor Scale was assessed at 6 months. Statistical analyses included simple regression and correlation analyses in relation to vitamin B12 status and gestational age.. Intrauterine growth restriction and stillbirths were correlated with maternal macrocytic anemia and hypersegmented polymorphonuclear nuclei. Postpartum maternal vitamin B12 intake influenced breastmilk vitamin B12 levels 1 to 6 months postpartum. No associations were found between vitamin B12 intake during pregnancy or vitamin B12 levels in breastmilk and infant length, weight, or head circumference at birth or 6 months. Vitamin B12 intake during pregnancy was correlated with improved scores on infants' BNBAS reflex subscale (R = -0.19, p = .05) with adjustment for gestational age. Bayley Motor Scale results at 6 months were not significantly associated with breastmilk or supplemental feeding vitamin B12 content.. Vitamin B12 deficiency may adversely affect pregnancy outcome, infant reflexes at birth, and breastmilk vitamin B12 content.

Topics: Adult; Anthropometry; Diet; Female; Fetal Growth Retardation; Humans; Infant; Infant, Newborn; Kenya; Lactation; Milk, Human; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Rural Population; Stillbirth; Vitamin B 12; Vitamin B 12 Deficiency; Zea mays

Vigabatrin (VGB) has several therapeutic advantages over older antiepileptic drugs (AED), but there is a lack of information about its potential reproductive toxicologic effects. Our aim was to evaluate the consequences of VGB administered during late gestation on fetal growth and development in the mouse. Based on the results of our previous study, we administered groups of mice a single dose of 450 mg/kg VGB on one of gestation days (GD) 15, 16 or 17. Fetuses were collected on GD 18. VGB groups had a significant incidence of fetal death, abortion, intrauterine growth restriction (IUGR), and hypoplasia of the axial skeleton, metacarpals, metatarsal and phalanges. Abortion was characterized by visible hemorrhagic expulsion of the embryos with their membranes. Maternal plasma folate (FA) and vitamin B12 concentrations were found to be markedly reduced within 12h of VGB treatment. Mice were supplemented with FA from GD 12 through GD 17 with or without a single dose of VGB on GD 15. This group had no abortions. Their fetuses had better body weight and lower frequency of IUGR than those of the non-supplemented VGB group. These data suggest that reductions in maternal FA and vitamin B12 concentrations play an important role in fetal loss, IUGR and skeletal hypoplasia induced by VGB during late gestation in the mouse. In view of the finding that a significant maternal toxicity is associated with this dose regimen, additional groups of mice were treated with 350 mg/kg VGB during embryogenesis and late gestation. This treatment was found to be maternally nontoxic. However, this low dose also resulted in significant fetal loss and IUGR when treatment occurred during late gestation. These data support the hypothesis that late gestation is particularly susceptible to VGB-induced fetal loss and IUGR in the mouse.

Topics: Animals; Anticonvulsants; Bone and Bones; Dietary Supplements; Embryonic Development; Female; Fetal Development; Fetal Growth Retardation; Fetus; Folic Acid; Mice; Mice, Inbred Strains; Musculoskeletal System; Pregnancy; Reproduction; Stillbirth; Vigabatrin; Vitamin B 12