{
  "abstract": "Background Vitamin B 12 deficiency is common in populations with limited animal-source foods and has been linked to delayed infant neurodevelopment and adverse pregnancy outcomes. Evidence on the benefits of maternal B12 supplementation for improving infant neurodevelopment remains mixed, particularly in low-income and middle-income countries where deficiency is prevalent.Methods This double-blind, randomised controlled trial was conducted in two tertiary maternity care centres in India and Nepal. Pregnant women in their first trimester, following a vegetarian diet, were enrolled and randomised to receive either a daily oral supplement of 250 µg (group A) or 50 µg (group B) of methyl-cobalamin from enrolment to 6 months post partum. The primary outcomes were infant neurodevelopment assessed at 9–12 months using the Development Assessment Scale of Indian Infants and biochemical B 12 status in mothers and infants measured through blood tests.Results 531 mothers completed the study (group A n=255; group B n=276). There were no significant differences in baseline characteristics between mothers at both centres or in groups A and B. Mental developmental quotients (DQs) were higher in the infants of group A: 103.7 (7.7) than group B: 101.7 (8.8); p=0.008). This corresponds to a mean difference of 7.8 centiles (p=0.007). Mean motor DQs were not significantly different between the groups. Maternal vitamin B 12 levels rose from the first to third trimester in both groups, with a larger increase in group A (104.9 pg/mL (SD 159.1)) than group B (47.5 pg/mL (SD 118.0)), p<0.001. Holotranscobalamin levels improved similarly (p<0.001). All infant levels of vitamin B12 were within the normal range. Newborn anthropometry, APGAR scores and morbidity profiles were similar in both groups (p>0.05). Serum ferritin, vitamin D and folate were similar (p>0.05).Conclusions Daily supplementation with 250 µg of vitamin B 12 during pregnancy in vegetarian mothers significantly improved infant mental DQ and maternal B12 status compared with a 50 µg dose.",
  "authors": [
    {
      "affiliations": [
        "Department of Pediatrics & Clinical Epidemiology, Sitaram Bhartia Institute of Science and Research, New Delhi, Delhi, India"
      ],
      "name": "Jitender Nagpal"
    },
    {
      "affiliations": [
        "Queen Mary University of London Faculty of Medicine and Dentistry, London, UK",
        "Public Health Foundation of India, New Delhi, India"
      ],
      "name": "Manu Mathur"
    },
    {
      "affiliations": [
        "Department of Clinical Epidemiology, Sitaram Bhartia Institute of Science and Research, New Delhi, Delhi, India"
      ],
      "name": "Swapnil Rawat"
    },
    {
      "affiliations": [
        "UCL Great Ormond Street Institute of Child Health, London, UK"
      ],
      "name": "Atul Singhal"
    },
    {
      "affiliations": [
        "Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal"
      ],
      "name": "Rajendra Pant"
    },
    {
      "affiliations": [
        "Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal"
      ],
      "name": "Anita Shah"
    },
    {
      "affiliations": [
        "Wolfson Institute of Population Health, UCL, London, UK"
      ],
      "name": "Laura Nixon"
    },
    {
      "affiliations": [
        "Public Health Foundation of India, New Delhi, India"
      ],
      "name": "Vijay Kumar Mishra"
    },
    {
      "affiliations": [
        "Public Health Foundation of India, New Delhi, India"
      ],
      "name": "Deepti Nagrath"
    },
    {
      "affiliations": [
        "UCL Great Ormond Street Institute of Child Health, London, UK"
      ],
      "name": "Michelle Heys"
    },
    {
      "affiliations": [
        "UCL Great Ormond Street Institute of Child Health, London, UK"
      ],
      "name": "Mario Cortina-Borja"
    },
    {
      "affiliations": [
        "University College London, London, UK"
      ],
      "name": "Colin Michie"
    },
    {
      "affiliations": [
        "Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal"
      ],
      "name": "Jageshwor Gautam"
    },
    {
      "affiliations": [
        "Department of Neonatology, Paropakar Maternity and Women's Hospital, Kathmandu, Nepal"
      ],
      "name": "Shailendra Bir Karmacharya"
    },
    {
      "affiliations": [
        "Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal"
      ],
      "name": "Snighda Rai"
    },
    {
      "affiliations": [
        "UCL Great Ormond Street Institute of Child Health, London, UK",
        "Nottingham University NHS Trust, Nottingham, UK"
      ],
      "name": "Monica Lakhanpaul"
    }
  ],
  "title": "Maternal supplementation of vitamin B12 in predominantly vegetarian pregnant women improves their vitamin B12 status and the neurodevelopment of their infants: the MATCOBIND multicentric double-blind randomised control trial",
  "uid": "f9d62803-fc9e-5bb6-9a98-53031a92bdd7"
}