Table_1_Pre-conceptional Maternal Vitamin B12 Supplementation Improves Offspring Neurodevelopment at 2 Years of Age: PRIYA Trial.pdf
Background: The first thousand days window does not include the pre-conceptional period. Maternal pre-conceptional health has a profound influence on early embryonic development (implantation, gastrulation, placentation etc). Nutrition provided by B-complex vitamins is important for fetal growth, especially neural development. We report effects of a maternal pre-conceptional vitamin B12 and multi micronutrient (MMN) supplementation on offspring neurodevelopmental performance.
Methods: In the Pune Rural Intervention in Young Adolescents trial (PRIYA), adolescents (N = 557, 226 females) were provided with vitamin B12 (2 μg/day) with or without multiple micronutrients, or a placebo, from preconception until delivery. All groups received mandatory iron and folic acid. We used the Bayley's Scale of Infant Development (BSID-III) at 24–42 months of age to investigate effects on offspring neurodevelopment.
Results: Participants had similar baseline B12 levels. The levels improved in the B12 supplemented groups during pre-conception and pregnancy (28 weeks gestation), and were reflected in higher cord blood holotranscobalamin (holo-TC) levels compared to the placebo group. Neurodevelopmental outcomes in the B12 alone group (n = 21) were better than the placebo (n = 27) in cognition (p = 0.044) and language (p = 0.020) domains (adjusted for maternal baseline B12 levels). There was no difference in neurodevelopmental outcomes between the B12 + MMN (n = 26) and placebo group. Cord blood Brain Derived Neurotrophic Factor (BDNF) levels were highest in the B12 alone group, though not significant.
Conclusion: Pre-conceptional vitamin B12 supplementation improved maternal B12 status and offspring neurodevelopment at 2 years of age. The usefulness of cord BDNF as a marker of brain development needs further investigation. Our results highlight the importance of intervening during pre-conception.
History
References
- https://doi.org//10.1002/9780470514047.ch4
- https://doi.org//10.1111/j.1365-2796.2007.01809.x
- https://doi.org//10.1016/j.jpeds.2016.05.013
- https://doi.org//10.1016/j.mce.2016.06.006
- https://doi.org//10.1002/bdra.20841
- https://doi.org//10.1001/jama.2012.155925
- https://doi.org//10.1017/S0007114515002081
- https://doi.org//10.1016/j.bbi.2009.02.001
- https://doi.org//10.1016/j.neuroscience.2011.05.010
- https://doi.org//10.1016/j.metabol.2013.06.002
- https://doi.org//10.1007/s00125-007-0793-y
- https://doi.org//10.1038/ejcn.2017.29
- https://doi.org//10.1016/S0140-6736%2885%2992690-X
- https://doi.org//10.1159/000208161
- https://doi.org//10.3389/fendo.2021.619176
- https://doi.org//10.1177/156482650802900401
- https://doi.org//10.1017/S2040174411000778
- https://doi.org//10.3945/jn.113.187278
- https://doi.org//10.1007/s10995-018-2605-z
- https://doi.org//10.1146/annurev-neuro-062012-170354
- https://doi.org//10.1016/0140-6736%2891%2990133-A
- https://doi.org//10.1002/bdra.20086
- https://doi.org//10.1186/s40795-017-0143-5
- https://doi.org//10.1037/t14978-000
- https://doi.org//10.3945/ajcn.111.032268
- https://doi.org//10.3945/jn.109.118075
- https://doi.org//10.1186/s12884-016-1011-z
- https://doi.org//10.1179/147683009X388913
- https://doi.org//10.1017/S0007114519000746
- https://doi.org//10.1186/1471-2350-13-90
- https://doi.org//10.1371/journal.pone.0043448
- https://doi.org//10.1371/journal.pone.0129915
- https://doi.org//10.3945/jn.109.107359
- https://doi.org//10.1038/ejcn.2010.15
- https://doi.org//10.1371/journal.pone.0223000
- https://doi.org//10.1177/03795721211025448
- https://doi.org//10.1079/BJN2000312
- https://doi.org//10.1186/s12916-016-0633-3
- https://doi.org//10.1038/nrdp.2017.40
- https://doi.org//10.1016/S0140-6736%2818%2930312-X
- https://doi.org//10.1093/humupd/dmt041
CC BY 4.0