Skip to main content
SpringerLink
Log in

Vitamin B12 Metabolism and Status during Pregnancy, Lactation and Infancy

  • Chapter
Nutrient Regulation during Pregnancy, Lactation, and Infant Growth

Part of the book series: Advances in Experimental Medicine and Biology ((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.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

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.

    Article  PubMed  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.

    Article  PubMed  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.

    Article  PubMed  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.

    Article  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.

    Article  PubMed  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.

    Article  PubMed  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.

    Article  PubMed  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.

    Article  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.

    Article  PubMed  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.

    Article  PubMed  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.

    Article  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.

    Article  PubMed  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.

    Article  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.

    Article  PubMed  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.

    Article  PubMed  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.

    Article  PubMed  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.

    Article  PubMed  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.

    Article  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.

    Article  PubMed  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.

    Article  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.

    Article  PubMed  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.

    Article  PubMed  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.

    Article  PubMed  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.

    Article  PubMed  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.

    Article  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.

    Article  PubMed  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.

    Article  PubMed  CAS  Google Scholar 

  • Rosenblatt, D. S. and Cooper, B. A., 1987, Inherited disorders of vitamin B12 metabolism, Blood Reviews, 1:177.

    Article  PubMed  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.

    Article  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.

    Article  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

Author notes

  1. Lindsay H. Allen

    Present address: Department of Nutrition, University of California, Davis, CA, 95616-8669, USA

Authors and Affiliations

  1. Department of Nutritional Sciences, University of Connecticut, Storrs, CT, 06269-4017, USA

    Lindsay H. Allen

Authors
  1. Lindsay H. Allen
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. University of California-Davis, Davis, California, USA

    Lindsay Allen  & Bo Lönnerdal  & 

  2. University of California-Berkeley, Berkeley, California, USA

    Janet King

Rights and permissions

Reprints and permissions

Copyright information

© 1994 Springer Science+Business Media New York

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

Publish with us

Policies and ethics

Search

Navigation