3. Indicators of Cobalamin Status During Pregnancy, Pregnancy Outcome and Long-Term Effects on Offspring Health-EN

https://journals.sagepub.com/doi/full/10.1177/03795721241229502

Indicators of Cobalamin Status During Pregnancy, Pregnancy Outcome and Long-Term Effects on Offspring Health

Inadequate cobalamin status during critical periods of growth and development can have negative consequences on maternal and childhood health.

Introduction: Cobalamin plays a crucial role in fetal growth and development, affecting methionine supply, amino acid and nucleotide synthesis, and energy production. The dynamic nature of cobalamin status during pregnancy, influenced by physiological demands, necessitates the establishment of pregnancy-specific reference intervals.

Findings:

  • Maternal Cobalamin Status: Cobalamin levels decrease during pregnancy, with physiological demands and dietary patterns impacting status. Low maternal cobalamin has been linked to miscarriage, intrauterine growth retardation, and NTDs. Despite these associations, research outcomes are varied, with some studies finding no direct correlation between cobalamin status and adverse pregnancy outcomes.
  • Offspring Health: Low maternal cobalamin status has been implicated in adverse metabolic and neurodevelopmental outcomes in offspring. These associations may vary by gender and could involve epigenetic mechanisms. The increasing prevalence of cobalamin insufficiency, partly due to shifts towards plant-based diets, raises concerns about potential health impacts.
  • Dietary and Supplemental Cobalamin: The balance between folate and cobalamin is critical, with some studies suggesting that high folate status may exacerbate the negative effects of low cobalamin status. The widespread use of folic acid supplements without concurrent monitoring of cobalamin status warrants reconsideration.

Conclusions: The variability of cobalamin status during pregnancy and its implications for maternal and offspring health highlights the need for comprehensive monitoring and reference intervals tailored to pregnancy stages. The long-term consequences of maternal cobalamin insufficiency, particularly in the context of evolving dietary trends, require further investigation to inform guidelines for supplementation and dietary advice. The balance between cobalamin and folate intake during pregnancy emerges as a critical factor in preventing adverse health outcomes, necessitating a holistic approach to prenatal nutrition.